Mathematical disagreements occur when students challenge each other’s ideas related to a mathematical concept. In this research, we examined Hong Kong and U.S. elementary teachers’ perceptions of mathematical disagreements and their resolutions using a video-stimulated survey. Participants were directed to give particular attention to the mathematics embedded within the disagreement and approaches for resolving the disagreement. Results revealed incomplete knowledge structures for the selected mathematical topic for both Hong Kong and U.S. participants. Differences existed between the two groups regarding the resolution of the disagreement, as Hong Kong participants focused on the content within the resolution process while U.S. participants focused on the form of the resolution process. Both groups found value in mathematical disagreements but for different reasons. Hong Kong participants indicated that the mathematical disagreements supported them in identifying students’ misunderstandings. In contrast, U.S. participants reported that mathematical disagreements helped to identify areas in which students lacked prerequisite knowledge. Implications for future work are provided.