Background: As an effort to account for disparities in mathematics performance between American and East Asian middle school students, the present research aims to compare the relationship between learning styles (competitive and cooperative) and mathematics performance among middle school students between the USA and the three top-performing East Asian countries (Hong Kong, Japan, and Korea) in 2003 Programme for International Student Assessment (PISA). Results: Results from hierarchical linear model (HLM) with students nested within schools demonstrated three key findings: (a) competitive learning had a statistically significant positive though small relationship with mathematics performance in all four countries, (b) cooperative learning had a statistically significant positive though small relationship with mathematics performance in the three East Asian countries but not in the USA, and (c) the relationship between competitive learning and mathematics performance was as strong as the relationship between cooperative learning and mathematics performance across the three East Asian countries. Conclusions: Although American students are stronger competitive and cooperative learners than their East Asian peers, they are not effective users of either learning style for the improvement of mathematics performance likely because of the way that both learning styles are practiced in American mathematics classrooms. Teacher education may hold the key to improve the educational practice of different learning styles as a strategy to improve mathematics performance of students in the USA and beyond.