This paper aims to investigate the performance of the students in the United States in all 84 mathematics items that were administered in the United States as part of the PISA 2012 assessment. It compares the performance of the United States with the OECD average and with the performance of five reference countries/economies that were ranked higher on the PISA scale. The analysis reveals specific relative strengths and weaknesses of the 15-year-olds in the United States, referring to items in which they performed unexpectedly well or unexpectedly badly compared to their overall distance from the OECD average or from the reference countries/economies. On that basis, certain patterns – that means certain clusters – of items with similar cognitive requirements, are identified. There are seven altogether, three for strengths and four for weaknesses of the US students. An analysis of student solutions illustrates and further clarifies these strengths and weaknesses. The results show that the relative strengths are mostly revealed in easy items, whereas the relative weaknesses are mostly reflected in particularly demanding items.