| Summary: | Abstract Background Worldwide, problematic test anxiety is a common health problem among medical students. The magnitude of problematic test anxiety ranges from 25 to 40% in undergraduate medical students and has a detrimental effect on academic achievement and success of students. However, data on the prevalence of test anxiety among medical students is limited. Thus, the study aimed to assess the prevalence and associated factors of test anxiety among medical students. Methods In this cross-sectional study, a stratified random sampling technique was used to select the participants. The level of test anxiety was determined by the Westside Test Anxiety Inventory (WTAI). We utilized logistic regression to explore the association between test anxiety and the potential sociodemographic/student-related characteristics among medical students. Results The study included 423 medical students. Our study resulted the prevalence of problematic test anxiety among medical students to be 52.30% (95% CI 47.40–57.30). The prevalence of test anxiety was remarkably higher in women (79.75%) than in men (33.62%) students. Female sex [AOR = 3.25, 95% CI: (1.54, 6.89)], having low grade [AOR = 0.11,95% CI: (0.044,0.288)], being first year [AOR = 10.55,95% CI: (1.4,76.7)], excessive course load [AOR = 6.128,95% CI: (2.675,14.039)], and taking oral examination [AOR = 2.89,95% CI: (1.42,5.84)] were determined as some of the predicting factors of test anxiety among medical students. Additionally, lack of systemic study plan [AOR = 2.4, 95% CI: (1.25, 4.59)], poor social support [AOR = 3.6, 95% CI: (1.56, 8.29)], moderate social support [AOR = 3.39, 95% CI: (1.56, 7.4)], psychologically distressed [AOR = 2.68, 95% CI: (1.37, 5.27)] independently predicts test anxiety among medical students. Conclusion Findings suggest that a substantial percentage of medical students had problematic test anxiety in Ethiopia (52.30%). This study also showed a significant association between test anxiety and female sex, having poor grade point average, being the first year, excessive course load, oral examination, lack of study plan, poor social support, moderate social support, and having psychological distress. Problematic test anxiety, which is found to be common among medical students, deserves more attention.
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