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Research has documented complex interactions between affect and cognition in students' mathematics learning as well as ways students' linguistic and cultural backgrounds may impact their mathematics learning and the types of affect they experience. Issues of language, culture and affect are especially salient when students engage in discourse regarding conceptually challenging mathematics, and teacher interventions may be significant in determining their subsequent mathematical engagement. This study examined how three middle school mathematics teachers addressed issues of language, culture and affect when responding to students' mathematics difficulties in linguistically and culturally diverse urban mathematics classrooms. Results indicate all the teachers considered language, culture, and/or affect when responding to students' mathematics challenges and suggest import for future researchers investigating these complex dimensions.