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Objective: To determine the examination stress and anxiety score during COVID-19 pandemic and to identify coping mechanisms adapted by medical students. Study Design: Cross-sectional study. Place and Duration of Study: Sir Syed College of Medical Sciences for Girls, Karachi, from Apr-May 2021. Methodology: A total of 250 students were recruited in the study and validated questionnaire was used for data collection. Test anxiety scores were calculated from a previous study scale by Nist and Diehl (1990). Data was analyzed by using SPSS-23. Results: The mean age of students was 20.1 ± 0.6 years. 74 (29.6%) students felt stress sometimes, 40 (16.0%) students felt always and 30 (12.0%) students never felt stressed before examination. Students who reported improved performance during the examination due to stress were 121 (48.4%). 76 (30.4%) students reported decrease in performance and 53 (21.2%) reported that their stress did not affect their performance. Students were inquired regarding the methods to cope the stress. 78 (31.2%) students reported that they took study break, 66 (26.4%) students spent time with family and friends, 49 (19.6%) found solace in sleep, 30 (12.0%) students listened to music, 13 (5.2%) used beverages (tea, coffee), 11 (4.4%) used numerous combinationsof methods, and only 3 (1.2%) students exercised. It was found that 158 (77%) students experienced healthy anxiety, 68 (27.2%) unhealthy anxiety, and 22 (8.8%) students were anxiety-free. Conclusion: Examination stress among medical students has increased during COVID-19 and various coping methods are used by the students to prevent anxiety. College.....