This study investigated the physiological and biochemical responses to examination stress among undergraduate students at Soran University using a within-subject design. A total of 25 students were assessed during a non-examination period (baseline) and an examination period (stress condition). Biochemical markers, including cortisol, α-amylase, and blood glucose, were measured alongside psychological indicators using the Perceived Stress Scale (PSS) and State–Trait Anxiety Inventory (STAI). The findings revealed a significant increase in psychological stress during the examination period, with elevated PSS (p = 0.048) and STAI (p = 0.014) scores. However, no statistically significant differences were observed in cortisol, α-amylase, or glucose levels between the two conditions. Correlation analysis showed no significant associations between cortisol or α-amylase and psychological stress markers. Notably, a significant negative correlation was observed between glucose levels and perceived stress (r = −0.437, p = 0.023). Additionally, lifestyle factors such as wake time and meal timing were significantly associated with certain biochemical markers, suggesting they may be confounding variables. In conclusion, examination stress significantly impacts psychological well-being without inducing pronounced biochemical changes. These findings highlight the complex and multidimensional nature of stress responses in academic environments. Keywords: Examination stress, Cortisol, α-amylase, Glucose, PSS, STAI
