This paper presents findings from a case study on the impact of high stakes oral performance assessment on third year mathematics students' approaches to learning (Entwistle and Ramsden, Understanding student learning, 1983). We choose oral performance assessment as this mode of assessment differs substantially from written exams for its dialogic nature and because variation of assessment methods is seen to be very important in an otherwise very uniform assessment diet. We found that students perceived the assessment to require conceptual understanding over memory and were more likely to employ revision strategies conducive to deep learning (akin to conceptual understanding) when preparing for the oral performance assessment than when preparing for a written exam. Moreover, they reported to have engaged and interacted in lectures more than they would have otherwise, another characteristic conducive to deep learning approaches. We conclude by suggesting some implications for the summative assessment of mathematics at university level. Keywords Case study. Oral performance assessment. Students' approaches to learning. University mathematics Mathematics is an academic discipline that employs very few summative assessment methods at university level and researchers (Steen, 2006) have often called for a variety of its summative assessment. Amongst the methods in use, written, timed exams dominate and indeed in a recent survey of assessment methods in England and Wales, Iannone and Simpson (2011) found the written, timed exam to be the modal assessment method across their sample. At the same time, the general education literature perceives uniformity of summative assessment as problematic (Brown, Bull, & Pendlebury, 2013) and indicates that traditional written timed exams alone are not suitable to assess all the competencies that may be desirable to assess (Birenbaum et al., 2006).