Macao, a special administrative region of the People's Republic of China, participated in the Program for International Student Assessment (PISA) 2003 Mathematical Literacy Study. This seminal study, organized by the Organazation for Economic Co-operation and Development (OECD) involving 43 countries/economies, provides baseline information for all stakeholders in the educational arena to judge existing schooling practices and plan future mathematics education at both primary and secondary education levels. This paper seeks to examine pertinent student and school factors affecting mathematical literacy performance in Macao secondary schools, after taking into account Economic, Social and Cultural Status (ESCS)of the home, immigrant status and gender of student. Four issues pertaining to mathematics education in Macao schools are examined.