We study fermions derivatively coupled to axion-like or pseudoscalar fields, and show that the axial vector current of the fermions is not conserved in the limit where the fermion is massless. This violation of the classical chiral symmetry is due to the background axion field. We compute the contributions to this anomalous Ward identity due to the pseudoscalar field alone, which arise in Minkowski space, as well as the effects due to interaction with an external gravitational field. In all cases, these interactions induce terms in the axion effective action that can be removed by the addition of local counterterms. We perform our computations both perturbatively using Feynman graphs, as well as by studying the transformation properties of the path integral measure. Using the heat kernel method, we include the effects of gravity as well as gauge fields, and compute the anomaly. Finally, we verify our relation by considering derivatively coupled fermions during pseudoscalardriven inflation and computing the divergence of the axial current in de Sitter spacetime.