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It is widely assumed that different instructional methods may affect student performance in different ways. This study examines what mathematics teaching approaches practiced in algebra and geometry classrooms across Hong Kong, Chinese Taipei and US and the influences of these approaches on student performance using TIMSS 2015 eighth-grade data. It found that while procedural instruction was more popularly practiced in Hong Kong and Chinese Taipei, the conceptual instruction was more popularly practiced in the US in both algebra and geometry classrooms. Three teaching approaches emerged including conceptual, procedural and mixed instruction. However, no significant relationships could be identified between any of instructional approaches and student performance in any place.