Background <p>Academic stress is widely reported among students in higher education, particularly within health professions programmes that combine intensive academic workloads with early clinical exposure. While stress among medical and nursing students has been well documented, comparatively little is known about the nature and distribution of academic stress among emergency medical care (paramedic) students, particularly in low- and middle-income contexts.</p> Method <p>A cross-sectional survey was conducted among first- to fourth-year emergency medical care students at a South African university. Participants completed a web-based questionnaire comprising demographic items and the validated Student Stress Inventory (SSI), which assesses stress across physical, interpersonal, academic, and environmental domains. Descriptive statistics were used to summarise stress levels, and inferential analyses were conducted to explore differences by gender and year of study, as well as associations between stress domains.</p> Results <p>Most participants reported moderate academic stress, with stress distributed across academic, physical, interpersonal, and environmental domains. No statistically significant differences in overall stress were observed by gender or year of study. Moderate positive associations were identified between academic stress and both the physical and environmental stress domains.</p> Conclusion <p>These findings provide contextually grounded evidence of academic stress patterns in paramedic education and contribute to the international discourse on student well-being in health professions education. Understanding the multidimensional nature of academic stress may inform the design of supportive curricula and institutional strategies aimed at promoting student well-being across diverse educational contexts.</p>