Introduction: This article aimed at digging deep into distractors used for mathematics multiple-choice items. The quality of distractors may be more important than their number and the stem in a multiple-choice question. Little attention is given to this aspect of item writing especially, mathematics multiple-choice questions. This article provides an engaging but succinct literature review on the development of plausible distractors for mathematics multiple choice items. Methods: A literature review was conducted on developing effective distractors for mathematics tests. The review explored potential strategies for generating distractors that effectively assess students' understanding and problem-solving skills in mathematics. Results: Alternative sources of distractors other than students' misconceptions are provided to aid the development of plausible distractors for mathematics multiple-choice items. Discussion: Practical guidelines for judging distractors fit for mathematics questions are provided to help teachers improve their item writing skills based on literature and experience as a mathematics teacher. Common pitfalls in distractor development were identified to enable mathematics teachers to have a clear path for their work. Limitations: This article focused on the development of plausible distractors specifically for mathematics multiple choice questions. Conclusions: Test constructors must ensure aligning the distractors with the objectives of each lesson in order to make the distractors relevant to the demands of the item.