BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety is one of the problems of educational systems, this study was performed to compare test anxiety in objective structured clinical examinations (OS-CEs) and traditional assessment methods (TAM) among Undergraduate Midwifery Students. Methods: In this descriptive-analytical study, 52 students of Babol Midwifery College were participated in the study. 20 students were evaluated using TAM in November 2010, and 32 students were evaluated using the OSCE method in July 2011. Data were collected via a two-component questionnaire including demographic data and the test anxiety inventory (TAI). Results: All of midwifery students were women; the mean age of students, ages of father and mother’s were 23.1 ± 0.7, 52.3 ± 3.5 and 47.8 ± 4.9 years, respectively. Most of the students were single (61.5%). The mean education levels of father and mother’s were 11.6 ± 4.5 and 9.9 ± 4.0 years, respectively. The mean score of test anxiety in students was 42.51 ± 13.16. The most of participants did have moderate test anxiety (56.9%), two present not had any test anxiety, 37.3% had low test anxiety, and 3.9% had severe test anxiety. In sum, 98% had some degrees of test anxiety. There were the statistical differences in the mean score of text anxiety in OSCEs Compared with TAM in Undergraduate Midwifery Students (39.38 ± 13.81 vs. 47.35 ± 10.67, P = 0.033). Also, the mean severity of anxiety was different in two groups. The mean of moderate/severe test anxiety was more in TAM compared with OSCEs (52.57% vs. 49.56%, p = 0.000). The test anxiety had a positive correlation with father’s education, mother’s education (0.286, p = 0.042), father’s age, mother’s age, marital status, residency (0.292, p = 0.042). Also, there are negative correlations with student age, satisfaction, total Grade Point Average (GPA) (-0.387, p = 0.007), final score, type of assessment (-0.298, p = 0.033). There is a significant difference between the severity anxiety residency in total (p = 0.10) and OSCEs (p = 0.049) groups, mother’s education in total (p = 0.005) and OSCEs groups (0.012) and GPA (p = 0.028). Conclusion: OSCEs were superior to TAM in the reduction of test anxiety in midwifery students. The prevalence of test anxiety was in TAM than OSCEs method; therefore, using OSCEs is acknowledged as an effective assessment tool and is seen as the gold standard for evaluating clinical performance.