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This systematic review analyzed Generative AI research in mathematics education from December 2022 to April 2025, following PRISMA guidelines. From 561 initial records, 28 peer-reviewed studies from 16 countries met inclusion criteria. Pre-service teachers were the most studied participants, while ChatGPT dominated AI tools examined. Four research themes emerged: GenAI Performance Assessment, Teacher Preparation, Student Learning Impact, and Technology Acceptance. Most critically, only one study employed rigorous experimental design with pre-post assessments necessary for establishing causal relationships between GenAI interventions and learning outcomes. Despite widespread adoption, empirical evidence supporting GenAI effectiveness in mathematics education remains severely limited. Current research prioritizes technology capabilities over educational effectiveness, highlighting urgent need for controlled experimental studies to inform evidence-based practice.