This systematic review of Technological Pedagogical and Content Knowledge (TPACK) research in primary mathematics education (2005–2022) identifies five key research foci: lesson design, evaluation of mathematics teachers' knowledge of integrating digital technologies, assessment design, evaluation of teacher training programs, and guidance for professional development program design. The TPACK framework, derived from pedagogical content knowledge (PCK), emphasizes the integration of technology, pedagogy, and content knowledge. It has been widely used in educational research to evaluate teachers' digital technology knowledge. However, there are gaps in measuring TPACK for primary mathematics teachers, designing TPACK instruments that include contextual factors, and developing TPACK-oriented teacher training programs. The review highlights the importance of using mixed-methods approaches to better understand TPACK in primary mathematics education. It also notes the increasing use of TPACK instruments to assess teachers' digital technology knowledge, with a preference for 5-point Likert scales and diverse item development strategies. The research landscape shows a growing interest in TPACK in primary mathematics education, with a peak in 2018 and 2019, but a need for more comprehensive exploration of mixed-method studies. The findings suggest that TPACK is crucial for informing lesson design, assessment, teacher training, and professional development in primary mathematics education. The review underscores the importance of considering cultural nuances and the unique needs of young learners when integrating technology in primary mathematics education. Overall, the study provides valuable insights for educators, researchers, and policymakers to enhance the integration of digital technology in primary mathematics education.This systematic review of Technological Pedagogical and Content Knowledge (TPACK) research in primary mathematics education (2005–2022) identifies five key research foci: lesson design, evaluation of mathematics teachers' knowledge of integrating digital technologies, assessment design, evaluation of teacher training programs, and guidance for professional development program design. The TPACK framework, derived from pedagogical content knowledge (PCK), emphasizes the integration of technology, pedagogy, and content knowledge. It has been widely used in educational research to evaluate teachers' digital technology knowledge. However, there are gaps in measuring TPACK for primary mathematics teachers, designing TPACK instruments that include contextual factors, and developing TPACK-oriented teacher training programs. The review highlights the importance of using mixed-methods approaches to better understand TPACK in primary mathematics education. It also notes the increasing use of TPACK instruments to assess teachers' digital technology knowledge, with a preference for 5-point Likert scales and diverse item development strategies. The research landscape shows a growing interest in TPACK in primary mathematics education, with a peak in 2018 and 2019, but a need for more comprehensive exploration of mixed-method studies. The findings suggest that TPACK is crucial for informing lesson design, assessment, teacher training, and professional development in primary mathematics education. The review underscores the importance of considering cultural nuances and the unique needs of young learners when integrating technology in primary mathematics education. Overall, the study provides valuable insights for educators, researchers, and policymakers to enhance the integration of digital technology in primary mathematics education.