The present integrative data analysis examined gender differences in achievement, achievement profiles, and achievement motivation in mathematics, reading, and science among 113,864 top-performing adolescent math students (top 5% in their respective countries). To do this, we applied the same analysis protocol to representative individual participant data from six cycles of the Programme for International Student Assessment (PISA 2000-2015; 82 countries) and integrated the results by using meta-analytical random coefficient models. We found that in the group of top-performing math students, male students were overrepresented (mean female-to-male ratio 1:1.50, 95% CI [1:1.58, 1:1:43]). Furthermore, female students possessed better reading skills (mean d = -0.23, 95% CI [-0.25, -0.21]) and more positive reading attitudes (-0.64, 95% CI [-0.69, -0.60] [less than or equal to] mean d [less than or equal to] -0.38, 95% CI [-0.46, -0.30]). Male students had stronger math self-efficacy (mean d = 0.32, 95% CI [0.28, 0.35]) and demonstrated mathematics-oriented achievement profiles, whereas female students' profiles were more balanced across domains. Moreover, female students were more interested in organic and medical fields (-0.44, 95% CI [-0.48, -0.40] [less than or equal to] mean d [less than or equal to] -0.30, 95% CI [-0.34, -0.25]), whereas male students showed greater interest in physics-related topics (0.39, 95% CI [0.36, 0.43] [less than or equal to] mean d [less than or equal to] 0.54, 95% CI [0.50, 0.58]). Gender equality indicators moderated the proportion of female students in the top 5% in mathematics and explained variability in achievement profiles across countries. Results are explained by social role theory and situated expectancy-value theory, and implications for women's underrepresentation in (specific) STEM fields are discussed.