Anxiety disorders are some of the most widespread mental health issues worldwide. In educational settings, individuals may suffer from specific forms of test and performance anxiety that are connected to a knowledge domain. Unquestionably, the most prominent of these is math anxiety. Math anxiety is a widespread problem for all ages across the globe. In the international assessments of the Programme for International Student Assessment (PISA) studies, a majority of adolescents report worry and tension in math classes and when doing math. To understand how math anxiety takes effect, it has to be regarded as a variable within an ensemble of interacting variables. There are antecedents that facilitate the development of math anxiety. They concern environmental factors such as teachers’ and parents’ attitudes toward their students’ and children’s ability in math, societal stereotypes (eg, on females’ math abilities), or personal factors such as traits or gender. These antecedents influence a number of variables that are important in learning processes. Math anxiety interacts with variables such as self-efficacy or motivation in math, which can intensify or counteract math anxiety. Outcomes of math anxiety concern not only performance in math-related situations, they can also have long-term effects that involve efficient (or not-so-efficient) learning as well as course and even vocational choices. How can math anxiety be counteracted? A first step lies in its correct diagnosis. Questionnaires for the assessment of math anxiety exist for all age groups, starting at primary education level. Help against math anxiety can be offered on different levels: by educational institutions, by teachers and a change in instructional approaches, by parents, or by the affected person. However, much more research is needed to develop effective measures against math anxiety that are tailored to an individual’s characteristics and needs.