This study examines the relationship between Achievement in Mathematics, Medium of Instruction and Mathematics Anxiety among 8th-grade students in District, Hamirpur, Himachal Pradesh. The primary objective is to explore how Mathematics Anxiety and Medium of Instruction, especially English and Hindi, impact Achievement in Mathematics. A sample of 162, 8th-grade students from various schools in Himachal Pradesh was selected. Data were collected using standardized mathematics achievement tests and a validated Mathematics Anxiety questionnaire. Contrary to common expectations, the findings reveal that students with higher levels of Mathematics Anxiety achieved higher scores. Furthermore, students taught in English medium outperformed their Hindi medium counterparts. These results suggest that while Mathematics Anxiety is generally perceived as detrimental, it may also drive certain students to achieve better results. Additionally, the Medium of Instruction plays a crucial role in shaping mathematics achievements, with English medium instruction providing a notable advantage in Achievement in Mathematics. The study concludes that educational strategies should consider both the Medium of Instruction and the complex role of Mathematics Anxiety in learning to enhance student Achievement in Mathematics.