Introduction: In the process of growing, adolescents experience stress and their coping abilities determine the outcome. School training further adds to this stressful situation. It is noteworthy that persistently high stress levels will impair students' academic achievement, personal and professional development. This article describes the prevalence of stress, stressors and coping strategies among secondary school students in Kota Bharu, Kelantan, Malaysia. Methodology: A cross-sectional study was conducted on secondary school students in Kota Bharu, Kelantan, Malaysia. Secondary school and participant selections were done via stratified random sampling with a sample size of 505 students. The 12-item General Health Questionnaire (GHQ-12), Secondary School Stressors Questionnaire (3SQ) and Brief COPE inventory were self-administered to measure stress level, sources of stress and coping strategies respectively among the participants. Results: Out of 505 selected participants, 421 (83.36%) responded to this survey. This study found that the prevalence of distressed secondary school students was 32.8%. The major stressors for all types of schools were academic-related issues. This study showed that the students in technical school were more distressed than students elsewhere. Among the most frequent coping strategies used by the students were religion, positive reinterpretation, use of instrumental support, active coping and planning. There were relationships between intrapersonal and interpersonal related stressor, academic achievements, level of school and academic related stressor, attention from parent, behavioral disengagement, self-blame and planning coping strategies with stress level of the students. Conclusion: This study found that there was a high prevalence of distressed negatively stressed secondary school students, the major stressors were related to academic and contributing factors of stress were related to school training, students and parents. Training students on positive coping strategies, reducing stressor-related school training, and improving parent and teacher supports to the students will help to improve this condition.