Background: academic stress can be prescribed as mental distress with respect to some anticipated frustration associated with academic failure or even awareness of the possibility of such failure. Medicine in specific is one of the most stressful fields of education because of its highly demanding professional and academic requirements, highly extensive medical curricula, repeated difficult exams and fear of failure all are causes of persistent stress and anxiety for medical students. Student's ability to handle these increasing demands of medical school can affect their academic success and emotional health. Experiencing stress and anxiety is beneficial to some extent as it can enhance the academic performance. In the other hand, increasing levels of stress that students exposed may have a negative effect on their cognitive functioning and learning abilities in the medical school. Coping is an important key point of dealing with stress and preventing psychological problems. Aim of the work: this studyexplored the impact of usage of different coping strategies on academic performance of students of College of Medicine in Al-Ahsa, 2018 and which type they use more than the other and which of these different strategies comprise more satisfaction than the others do. Methods: this wasa cross sectional study was carried out among female students in college of medicine in king Feisal University in the academic year 2017-2018. Data had been collected by electronic and paper survey, which contained demographics, educational level, family income, GPA, studying hours and the Lazarus's ways of coping framework, which was a widely accepted model containing 66 points that distinguishes between distinct active and emotion based coping methods. Results: 73 students were completed the survey, 58.9% of them reported being upset\sad for significant amount in 2 weeks period, and 49.3% of students report that they feel they need psychiatric consultation. No significant association was noticed between GPA and each of coping strategies addressed in this study. Positive reappraisal was the most used strategy by 76.86%, while confrontive coping was the least to use by 55.83%. Conclusion: medical students were more vulnerable to academic stress due to highly demanding professional and academic requirements. To overcome this, students used different coping strategies.According to our study, there was no significant impact on the GPA or difference between these strategies.