In 2003, about 50 countries including Ghana participated in the Trends in International Mathematics and Science Study (TIMSS). This is the first time that Ghana has participated in an international mathematics assessment that has provided the reliable data to examine equity and the quality of mathematics education within schools in Ghana. In the TIMSS assessment, the average Ghanaian student scored 276 compared to the international average of 466. This paper employed a multilevel framework to explore the schooling processes that provide opportunities for Ghanaian students to successfully learn mathematics. My analysis indicates that there is a significant variation among schools in their students' mathematics outcomes. The most successful students are males with highly educated parents. These students have high academic expectation, like mathematics and are confident learning mathematics. They attend schools that are often located in towns but not in villages or remote areas. In these schools, the parents of students are highly educated, and the mathematics teachers do not frequently use calculators but often provide students the opportunity to explain their mathematical ideas. These findings demonstrate that efforts to improve the quality of mathematics education and ensure equity in mathematics outcomes would require a comprehensive and holistic approach involving students, parents, and teachers.