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Prior reviews of game-based learning (GBL) typically focused on providing a synopsis of the overall research trends and its impact on cognitive and emotional learning, without providing critical and contextual information of learning-gameplay integration or the game design features. The current review focuses on empirical studies that implement learning games for K-12 mathematical education during the time period of 2008 to 2018 via a systematic search of databases. Thirty-one papers were identified using a three-stage data extraction process. We identified the approaches to designing and integrating math content in gameplay. The review findings support that learning games could act as a dynamic platform to transform abstract math knowledge into concrete and visual objects or representations.