Academic examination stress is reported to increase physiological and self-report measures of stress and to decrease immune functioning. Here, we investigate biochemical and self-report measures of stress, immune functioning, and academic pressures before and during a midterm examination period. Undergraduate students were asked to complete a measure of global stress, the perceived stress scale (PSS-10), and to indicate their current level of perceived stress. They also answered questions regarding specific academic pressures and provided a saliva sample for cortisol and salivary immunoglobulin-A (S-IgA) quantification. Students showed increased salivary cortisol concentrations and also reported greater acute perceived stress during the examination period compared to the non-examination period. Although cortisol concentrations and perceived stress were significantly higher during the examination period, participants reported similar levels of global stress (PSS-10) during both testing sessions. Additional analyses showed a non-significant increase in the level of S-IgA from the non-examination period to the examination period. Specific pressure variables that appeared to contribute to stress regulation during the examination week included the amount of time spent studying and concern about the impact of examinations in the future. By demonstrating measures of chronic examination stress, these findings provide new insight into the complex relationship between examination stress, cortisol, and immune functioning.