Background <p>While objective structured clinical examination (OSCE) is a widely used method for assessing clinical competencies in dentistry, it can be a significant source of anxiety for students. Neither the extent to which dental students experience anxiety related to this exam nor the students’ perceptions of the test’s clinical value have been formally measured.</p> Objective <p>This study assessed post-OSCE anxiety in 5th-year dental students, explored gender differences, and evaluated perceptions of realism and educational value compared with prior clinical practice.</p> Methods <p>This was a cross-sectional study of 5th -year dental students with a bachelor’s degree in dentistry at the European University of Madrid (2023–2024). After completion of the OSCE, each student anonymously completed the State-Trait Anxiety Inventory (STAI), a validated questionnaire designed to measure their state of anxiety, and they reported their perception of the clinical relevance of the OSCE. The overall STAI scores and a comparison of male and female scores were recorded.</p> Results <p>A total of 229 dental students completed the OSCE, 200 of whom participated in our study. 82% of the students reported “medium-high” or “very high” anxiety levels. Males presented significantly higher median anxiety scores than females did. No relationship was found between age and anxiety level, regardless of sex. A total of 83.5% of the students felt that the stations were representative of real life and that their previous clinical experience with patients during their two years of clinical internships had prepared them well for the OSCE, enabling them to demonstrate their professional skills. 92% of the students passed the exam.</p> Conclusions <p>OSCE induces moderate to high levels of anxiety in dental students, particularly among males. Despite this, students generally view the OSCE positively, considering it a useful, realistic, and formative tool.</p>