In most years, students have taken the USAMO at their respective high schools. Prior to 2002, the problems were mailed to the schools in sealed envelopes, not to be opened before the appointed time on the test day. Since 2002, test problems have been posted on the AMC web site (see links below) fifteen minutes prior to the official start of the test. Student responses are then faxed back to the AMC office at the end of the testing period.
In 2002, the Akamai Foundation, as a major sponsor of the American Mathematics Competitions, invited all USAMO participants to take the test at a central event at MIT in Cambridge, Massachusetts, all expenses paid. In addition, Akamai invited all 2002 USAMO participants who were not high school seniors (approximately 160 students) to take part in an enlarged MOP program. Since holding this central event every year would be prohibitively expensive, it has been discontinued. In 2004 and 2005, however, funding was found to send 30 rising sophomores to MOP as well, in a program popularly called "Red MOP."
Each year, the top 12 scorers on the USAMO are considered for selection to the IMO team for the United States. The students are trained at the Mathematical Olympiad Program (also known as "MOP") in Lincoln, Nebraska, and then six are selected to the team. The next approximately 18 high scorers, usually excluding high school seniors, are also invited to MOP.