The Programme of International Student Assessment (PISA) has been administered to 15-year- olds every three years since 2000. Since then, the U.S. has performed below average in mathematics, with no significant changes in performance. The objective of this study was to examine the alignment of the content students in the U.S. are assessed on in the PISA to the intended content standards for U.S. students (Common Core State Standards in Mathematics; CCSS-M). Alignment was analyzed using the Surveys of Enacted Curriculum (SEC) Alignment Model. Implications for implementing the CCSS-M were evaluated, and content topics that the CCSS-M needed to address in order for students in the U.S. to be prepared for the real-world were determined. It was found that while all content domains are addressed by both the intended and assessed curriculum (CCSS-M and the PISA, respectively), the assessed curriculum is not addressed with as much emphasis by the intended curriculum. The key concepts assessed on the PISA are also not addressed by the intended curriculum in the years proximal to taking the PISA. Implications for the CCSSM and students in the U.S. are described based on results from this study.