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Quality classroom interaction is one of the variables that enhance quality learning outcomes in the teaching and learning process. This paper reports of a study which sought to investigate the nature of classroom interaction in the primary school and how that affects pupils’ opportunity to learn mathematical concepts meaningfully. Observation of mathematics lesson of two primary six teachers randomly selected from two average schools (one each from urban and rural areas) in the Cape Coast Metropolis of Ghana was carried out. This was followed by group interviews of twenty of the pupils (ten each from rural and urban schools) who participated in the lesson and their teachers. The data collected were analysed qualitatively and the results presented as narrative description with illustrative examples. The results from the study revealed that opportunities for pupils to learn mathematics meaningfully was inhibited mainly by language use, lack of knowledge of basic mathematical facts and lack of use of pupils’ everyday mathematical experiences in the development of concepts. The study suggests the use of an alternative model based on a three-tier teaching model for teaching mathematics in context (Davis, 2010; Davis & Ampiah, 2014), and presents examples of how primary school mathematics topics could be developed to promote pupils’ understanding.