Student mathematics performance and the need for work-ready graduates to be mathematics-competent is a core issue for many universities. While both student and teacher are responsible for learning outcomes, there is a need to explicitly acknowledge the weak mathematics foundation of many university students. A systematic literature review was undertaken of identified innovations and/or interventions that may lead to improvement in student outcomes for university mathematics-based units of study. The review revealed the importance of understanding the foundations of student performance in higher education mathematics learning, especially in first year. Pre-university mathematics skills were identified as significant in student retention and mathematics success at university, and a specific focus on student pre-university mathematics skill level was found to be more effective in providing help, rather than simply focusing on a particular at-risk group. Diagnostics tools were found to be important in identifying (1) student background and (2) appropriate intervention. The studies highlighted the importance of appropriate and validated interventions in mathematics teaching and learning, and the need to improve the learning model for mathematics-based subjects, communication and technology innovations.