Mathematical flexibility is thought to be a critical component of mathematical proficiency, and the term "mathematical flexibility" has been used by teachers, researchers, and policy makers for more than 2 decades. Although there seems to be consensus on the importance of mathematical flexibility as a construct, the way it is defined and described is inconsistent. Without a clear and consistent definition of mathematical flexibility, it is impossible to develop accurate measures of the construct or to improve instructional strategies to promote its use. Therefore, this systematic literature review examines the way mathematical flexibility has been defined, taught, and measured. Using a combination of descriptive statistics and qualitative content analysis, articles were coded for themes around definitions, instruction, and measurement. Finally, we looked at connectivity between authorship to examine relationships between citations of how mathematical flexibility was defined.