BACKGROUND: The inclusion of behavioral therapy and stress reduction techniques among vocational students of the Nigerian universities is crucial for enhancing their practical skill acquisition and career prospects in challenging academic scenarios. This study explored the combined effects of cognitive-behavioral therapy and mindfulness-based stress reduction in reducing test anxiety among business education students in a measurement and evaluation course. METHODS: Employing a randomized control trial with a pretest-posttest design, the research draws responses from 483 students from two universities in Southeast Nigeria. The participants were randomly assigned to either the treatment or waitlist control groups on the basis of set inclusion criteria. Data collection was conducted via four different instruments, and the treatment group participated in a Cognitive-Behavioral Therapy and Mindfulness-Based Stress Reduction (CBT-MBSR) program. Evaluations of both groups were conducted at three different stages: before the intervention, immediately after the intervention, and during the follow-up period. Analysis was carried out via repeated-measures ANOVA and multivariate analysis of covariance (MANCOVA). RESULTS: The results indicated that TVET students who underwent the CBT-MBSR intervention had significantly lower post-treatment test anxiety scores than those in the wait-list control group. The intervention also had a significant multivariate effect on reducing test anxiety, improved mindfulness, students' academic achievement, and their well-being (F value = 1168.52 (p =.001, η² = 0.752). CONCLUSION: This study assessed the efficacy of CBT with MBSR in reducing test anxiety, improving academic performance, and increasing well-being among students in TVET settings. The study revealed how CBT helped reduce test anxiety, thereby improving students' academic performance through increasing their concentration. Thus, this study provides fresh knowledge on how to improve psychological well-being and educational performance by introducing a new method of combining MBSR and CBT, which enriches the literature with a dual-modality approach that helps students reduce their anxieties and fosters their personal growth. This study has practical implications for university administrators, educators, and researchers and offers several recommendations. CLINICAL TRIAL NUMBER: Not applicable.