<![CDATA[Background: Research on spatial ability in mathematics education has increasingly incorporated diverse instructional approaches and digital technologies; however, evidence regarding how these approaches support spatial development remains dispersed across educational levels, spatial constructs, and intervention designs. Aims: This study synthesizes research published between 2015 and 2026 to identify instructional interventions for developing spatial ability and examine thematic and temporal patterns within mathematics education. Method: A PRISMA-guided systematic review was conducted using records retrieved from Dimensions and Scopus through Publish or Perish. Studies were screened using predefined eligibility criteria, resulting in 17 articles for systematic content analysis. VOSviewer was additionally employed to map keyword co-occurrence, thematic clusters, temporal patterns, and topic density. Results: The synthesis identified geometry, spatial reasoning, visualization, mental rotation, and mathematical problem solving as prominent themes. Reported instructional approaches included visualization and object manipulation, AR/VR, CAD and 3D printing, collaborative and metacognitive scaffolding, ethnomathematics, realistic mathematics education, and STEM-oriented activities. Outcomes varied across instructional designs and learning contexts. Conclusion: The evidence suggests that spatial development is better supported when visualization and object manipulation are embedded within structured, pedagogically scaffolded mathematics instruction.]]>
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