What does it mean to be mathematically gifted? Do all mathematically gifted students think and perform the same on math-related tasks? In this study, I present and describe four profiles are presented of mathematically gifted middle and high school students, all of whom exhibit high levels of mathematics achievement at school based on their mathematics content mastery, metacognitive abilities, and performance in accelerated mathematics courses. This study gives researchers, mathematics teachers, and parents a deeper understanding of the components that make students gifted in mathematics. Implications for future research and practice in schools are discussed.