Private tutoring has emerged as a significant educational phenomenon worldwide, often supplementing or compensating for gaps in formal schooling. In the Baltic States—Latvia, Estonia, and Lithuania—this practice has gained traction, particularly in mathematics, a subject pivotal for both academic success and future opportunities. This paper examines the prevalence, characteristics, and implications of private tutoring in mathematics for primary school students across the region, using data from the 2022 OECD PISA survey. The study addresses two key aspects: (1) the demographic and socio-economic profiles of students engaging in private tutoring and (2) the associations between private tutoring and performance in mathematics. It assesses the potential implications of private tutoring on educational equity and access. A comparative lens is applied to highlight similarities and differences among the three countries, reflecting their distinct yet similar educational systems as Estonia is top ranked among OECD countries in student performance in PISA tests, while Latvia and Lithuania, being above OECD average, lag behind the Northern neighbour.