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Test anxiety is alarmingly rising and has been shown to correlate with academic performance and affect occupations and well-being. Graduate occupational therapy (OT) students encounter a rigorous workload and pressure to become entry-level practitioners. Higher levels of baseline graduate student anxiety is correlated with increased test anxiety. Practical examinations are essential for assessing graduate OT students' higher learning and entry-level clinical skills. Educators are often challenged with identifying coping strategies to assist graduate OT students in reducing their test anxiety. Substantial research supports the use of music to reduce anxiety in adults. Seventy-five OT graduate students participated in this quasi-experimental study which explored the influence of background music on test anxiety during a lab practical examination. Participants completed pre- and post-outcome measures using the State-Trait Anxiety Inventory for Adults and the Test Anxiety Inventory and had their blood pressure and heart rate recorded. Results showed a significant main effect in the experimental group with music decreasing systolic blood pressure in participants with high state anxiety. Music had no significant interaction with mean arterial pressure, systolic blood pressure, diastolic blood pressure, heart rate, state anxiety, trait anxiety, test anxiety, or practical scores when comparing the experimental groups. Most participants indicated that background music assisted in decreasing anxiety experienced during practicals, and experimental group participants self-reported that background music was effective. Music intervention may be useful during practicals by reducing test anxiety. Additional studies would assist in further examining the efficacy of test anxiety reduction interventions with graduate OT students.