Introduction: In a social and educational context increasingly focused on the promotion of STEM competencies, mathematical skills represent key competencies of the 21st century and are essential for active and informed participation in contemporary society. Mathematics anxiety is a pervasive global issue that occurs across different cultural contexts and spans from childhood to adulthood.

It has significant repercussions on students’ performance and attitudes toward the subject. Despite this, most research has focused on secondary school and university, leaving the primary school context relatively underexplored. Understanding MA in the early years of schooling is crucial for developing preventive interventions and fostering a positive relationship with mathematics; therefore, this systematic review aimed to examine the relationship between MA and performance and identify intervention strategies.

Methods: The systematic review was conducted following the PRISMA 2020 guidelines. The databases Scopus, PubMed, and Google Scholar were consulted, considering publications from 2014 to 2024 in English, Italian, and Spanish. Meta-analyses, systematic reviews, and research articles on mathematics anxiety in primary school students were included. The search strategy used the keywords “math anxiety” AND “primary school.” Articles were selected through a screening process, and data were extracted and presented in tables reporting authors, study type, sample characteristics, methods, and main results.

Results: A total of 43 studies met the inclusion criteria. Evidence shows a negative relationship between mathematics anxiety and performance, even in the early years of schooling, suggesting a bidirectional relationship between anxiety and performance. The importance of teacher support also emerges, along with the need for interventions aimed at both enhancing mathematical competencies and managing students’ emotional experiences.

Conclusions: Early identification of mathematics anxiety and targeted interventions are essential to prevent avoidance behaviours and underachievement. The findings highlight educational implications useful for teachers and researchers, suggesting strategies to support emotional regulation and mathematical engagement in students.

Keywords: mathematics anxiety; primary school; STEM; 21st-century skills; academic performance; working memory.