<p>School principals face multiple complex responsibilities that extend beyond basic administrative tasks. Their roles involve school leadership, stakeholder management, and the enhancement of overall school performance. These demanding duties often produce significant stress, which can negatively affect their mental health. This issue has led to growing interest in examinations of stress among school principals. This article aims to compile, organize, and synthesize the existing body of knowledge on this topic. To guide the review, the Arksey and O'Malley framework for scoping reviews was utilized in conjunction with the PRISMA statement and the PRISMA-ScR checklist. Comprehensive systematic searches were performed in the Scopus and Web of Science databases for studies published between 2014 and 2024. Overall, 38 articles were identified from 18 countries, focusing on six key aspects of systematic literature analysis related to stress among principals: year of publication, geographical distribution, stressors, coping strategies, stress symptoms, and demographic differences. The findings indicate that researchers from the USA and Australia have contributed the majority of the literature concerning stress and mental health issues among principals. This review highlights how administrative workloads were a significant source of stress for this group, with many adopting coping strategies such as practical activities. Additionally, female principals tended to experience stress more frequently than their male counterparts. One recommendation for future research is that reviews should examine the impacts of social capital and social support on the mental health of school principals.</p>