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I report on a study that examines the complexity of test illustrations design across cultures. A coding system (Author, 2011) was used to code the presence of features of illustrations in 415 science items from China, the U.S., and TIMSS. I examined the formal properties of the illustrations and the relationship of those properties with student performance. Further analysis of exemplar illustrations in sub-content areas provides supporting evidence of how the features of illustrations varied across cultures. This study is critical to designing illustrated science items that are not culturally biased in the testing of culturally diverse populations within the U.S. and in the context of international test comparisons.