This study was undertaken to systematically analyze instructional interventions employed to enhance the mathematical performance of elementary school students with math learning difficulties (MLD). Over 20 years (2003-2023), 34 articles that met the inclusion criteria were included in the analysis. The articles in the study were analyzed in terms of methodological and intervention characteristics. Methodological characteristics were analyzed in two categories: participant characteristics and tests for identifying students. Intervention characteristics were analyzed in six categories: grade level, instructional intervention, implementer, implementation method, intervention duration, and mathematics learning area. It was found that the articles examined generally targeted students with MLD, and standardized achievement tests were used to identify students. The articles reviewed determined that third grade students were studied as participant students and strategy teaching was frequently used as an intervention programme. In the reviewed studies, the instructional interventions applied to students with math learning difficulties were implemented mainly by expert implementers in small-group teaching. It was observed that the number of sessions for instructional interventions ranged from 4 sessions to 96 sessions, with an average intervention duration of 16.91 hours. Finally, it was determined that the instructional interventions in the analyzed studies mainly focused on the learning domain of numbers and operations as the mathematics learning area.