Introduction: Increased levels of anxiety are lead to the lower performance of students in the exam situation. On the other hand, the self-efficacy is directly related to the academic performance of the students. 
Materials and Methods: in this cross-sectional study, 233 paramedical students of Qom University that had been randomly selected were participated in this study. The demographic information’s sheet, test anxiety inventory and the self-efficacy scale were used as data collection tools. Logistic regression analysis and Pearson correlation coefficient were used for data analysis.
Results: The score of test anxiety of %43.4 of the students was more than the mean of anxiety score. In the univariate logistic regression analysis, the increasing of self-efficacy score was associated with the decreasing of the of test anxiety. (OR: 0.79, %95  CI: 0.73-0.86) And also, the chance of test anxiety among the female students was more than males. (OR: 1.74, %95  CI:1.01-2.99) The age, marital status and the number of elapsed terms wasn’t significantly associated with the test anxiety. In multivariate logistic regression analysis, only self-efficacy predicts the test anxiety. (OR: 0.80, %95 CI: 0.73-0.87).
Conclusion: The findings of this study showed that the students with higher self-efficacy experience lower test anxiety. Therefore, the strengthening of this individual feature in students can lead to the better performance of students in the exam situation by decreasing of test anxiety. According to the existed difference between the sexes, the girls have more need to the self-efficacy promotion programs.