Using the Mantel-Haenszel (MH) Procedure, we analyzed data for 7,087 American and 4,022 Russian Grade 8 students from the Third International Mathematics and Science Study (TIMSS) to compare mathematics achievement in the two countries on each of the 124 multiple-choice items. The results of the analyses indicate that the performance of the students on individual multiple-choice mathematics items vary by country. The results also suggest that the relationship between country and item performance differ as a function of content area. A total score of a country's achievement does not provide the whole picture of achievement dynamics; it averages out potentially important information on student achievement and the causes of their performance relative to other countries. The dynamics of achievement across countries will not be revealed unless the analyses are done at the item level.