The exam consists of 15 questions, where each answer is an integer between 0 and 999 inclusive. Thus the test effectively removes the element of chance afforded by a multiple-choice test while preserving the ease of automated grading; answers are entered onto an OMRsheet, similar to the way grid-in math questions are answered on the SAT.

Concepts typically covered on the exam include topics in elementary algebra, geometry, trigonometry, as well as number theory, probability, and combinatorics. Many of these concepts are not directly covered in typical high schoolmathematics courses; thus, participants often turn to supplementary resources to prepare for the exam.

One point is earned for each correct answer, and no points are deducted for incorrect answers. No partial credit is given. Thus AIME scores are integers from 0 to 15 inclusive.

Some recent results are:

Year | Students
sitting | Mean
score | Median
score | Students with
perfect scores |

2006 | 22764 | 2.741 | - | 4 |

2005 | 12476 | 2.717 | 2 | 1 |

2003 | 13444 | 3.059 | 3 | 3 |

1999 | 11945 | 2.195 | 2 | 4 |

A student's score on the AIME is used in combination with their score on the AMCto determine eligibility for the USAMO. A student's score on the AMC is added to 10 times his/her score on the AIME. In 2006, the cutoff for eligibility in the USAMO was 217 combined points.

During the 1990s it was not uncommon for fewer than 2,000 students to qualify for the AIME, although 1994 was a notable exception where 99 students achieved perfect scores on the AHSME and the list of high scorers, which usually was distributed in small pamphlets, had to be distributed several months late in thick newspaper bundles.

The AIME began in 1983. It was given once per year on a Tuesday or Thursday in late March or early April. Beginning in 2000, the AIME is given twice per year, the second date being an "alternate" test given to accommodate those students who are unable to sit for the first test because of Spring Break, illness, or any other reason. However, under no circumstances may a student officially take both exams. The alternate test, commonly called the "AIME2" or "AIME-II," is usually given exactly two weeks after the first test, on a Tuesday in early April. However, like the AMC, the AIME recently has been given on a Tuesday in early March, and on the Wednesday 15 days later, e.g. March 7 and 22, 2006.