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It is widely assumed that different instruction practices affect student performance in different ways. This study examines the popularity of two kinds of mathematics teaching approaches that are practiced in the United States eighth-grade classrooms and the influences of these approaches on student performance using TIMSS 2015. It found that although conceptual based instruction was more popularly practiced than procedural based instruction in the US eighth-grade mathematics classrooms, no significant relationships could be identified between any of instructional approaches and student achievement in knowing, applying, and reasoning. However, student socioeconomic status and self-concept exerted significant and positive influences on student mathematics achievement in each of the three areas.