Background: Medical students confront stress throughout their course. It has been reported that 60% of students suffer from anxiety and depression during their study period. The leading cause for anxiety is an examination stress. A poor academic performance has been observed in students with high test anxiety than in those with low test anxiety. Aims and Objectives: The present study was conducted to determine the prevalence of exam anxiety among medical students, to evaluate any significant difference in exam anxiety level between male and female students, and to assess the factors causing it. Materials and Methods: The present study was conducted on 300 medical students of three phases in the age group of 18-23 years. The prevalence of exam anxiety was determined by westside test anxiety scale. The factors causing exam anxiety included in the survey questionnaire were related to examination system, lifestyle, study style, and psychological problems. Results: The prevalence of high exam anxiety among Phases I-III were 37%, 28%, and 32%, respectively. The high exam anxiety level was more in males than in females. Examination system, lack of time management and extensive course load was the major contributing factors for anxiety related to the examination. Conclusion: Medical teachers need to be aware of the factors causing exam anxiety, and the university needs to develop curriculum and examination pattern keeping in view the difficulties students face.