Background: Medical students experience a considerable amount of anxiety due to exams. Emotion regulation and psychological resilience are established protective factors of individual mental health, however, the investigations for the effects of anxiety were limited. The goal of the present study was to examine the relationship of psychological resilience and emotion regulation with test anxiety and the associated factors of them among medical students. Methods: In this cross-sectional survey,

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... simple random sampling methods was used to select the participants. Information from a sample of 1266 medical students was collected by self-reporting questionnaires. Logistic regression was applied to test the associations between test anxiety and emotion regulation, resilience. Bootstrap were conducted to explore the mediating role of resilience. Results: Our important results were that the prevalence of problematic test anxiety among medical students to be 71.4%, 33.7% was high test anxiety. Gender and academic performance correlated significantly with test anxiety, emotion regulation, and psychological resilience. There were correlations between test anxiety and various dimensions of emotion regulation and psychological resilience ( P<0.01 ). Emotion regulation and psychological resilience predicted emerging test anxiety. The mediating role of psychological resilience was identified for the effects of emotion regulation on test anxiety. Conclusions: Findings suggest that emotion regulation affected test anxiety through psychological resilience, which may provide insights for clinical psychologists, raise their awareness of the importance of cultivating and improving medical students' psychological resilience, and prompt them to offer psychological support to students with test anxiety as early as possible. The combination of curing and self-healing can solve the root cause of the problem and truly apply psychological research to improving the mental health of the general public. Keywords: Psychological resilience, Test anxiety, Emotion regulation, Medical student