Swedish compulsory school for students with intellectual disability (ID) has been criticized for focusing on care and not presenting the students with enough knowledge-related challenges. The purpose of this study is to investigate how a conceptually-based mathematics curriculum can be interpreted and constructed for students with ID. A total of 18 mathematics lessons in 6 classes forstudents with ID were filmed, and the teachers were interviewed in connection with the lessons. Aqualitative content analysis approach was used to identify aspects of mathematical competency content and to analyze the teaching. Three major groups of teaching strategies are identified: pedagogical mathematics activities, focusing on students’ perceptions of mathematical content, and encouraging dialogue between students.