This systematic review explores test anxiety in children and young people (CYP) with learning difficulties. Research has found that students with learning difficulties experience higher levels of anxiety about school compared to peers without learning difficulties. One area of school that has had little research is test anxiety, therefore further exploration is needed. Nine papers resulted from the systematic search. It was found that CYP with learning difficulties can experience test anxiety. There are a variety of internal and external factors which have an interactional relationship with test anxiety. A model was developed to illustrate these factors including characteristics of tests, perceptions of support, self-belief and cognition and learning skills. This can be used to explore potential reasons for test anxiety in CYP with learning difficulties and to provide subsequent support.