The sequential nested mixed methods study focused on comparative analysis of middle school mathematics teachers’ content knowledge in two countries. The study consisted of two stages: (1) quantitative study of teacher content knowledge; (2) qualitative study of teacher topic-specific content knowledge. The initial sample for the first stage included lower secondary mathematics teachers from the U.S. (grades 6–9, N=102) and Russia (grades 5–9, N=97). The Teacher Content Knowledge Survey (TCKS) was applied to assess teacher content knowledge based on the cognitive domains of Knowing, Applying, and Reasoning, as well as addressing the lower secondary mathematics topics of Number, Algebra, Geometry, Data and Chance. The second stage – an interpretive cross-case study – aimed at the examination of the U.S. and Russian teachers’ topic-specific knowledge on the division of fractions. For the second stage, N=16 teachers (8 – from the U.S., and 8 – from Russia) were selected for the study using non-probability purposive sampling technique based on teachers’ scores on the TCKS. Teachers were interviewed on the topic of fraction division using questions addressing their content and pedagogical content knowledge. The study revealed that there are explicit similarities and differences in teachers’ content knowledge as well as its cognitive types. The study results may inform the field on priorities placed on lower secondary mathematics teachers’ knowledge in the USA and Russia. It also suggests close comparison and learning about issues related to teacher knowledge in both countries with a potential focus on re-examining practices in teacher preparation and professional development.