Academic stress is one of the primary factors threatening university students' well-being and performance. Undergraduate students who are working toward applying to medical school, defined as being on the premedicine or "premed" pathway, are suspected to have higher academic stress compared to their peers who are not premed. However, what factors contribute to academic stress for premed students is not well understood. We sought to answer the following: Do undergraduates perceive that premeds have higher, the same, or lower stress than nonpremeds? How do academic stress levels between these groups actually differ? What aspects of being premed cause academic stress? Who has left the premed track and why? We surveyed 551 undergraduates from one large institution in the United States and answered our research questions using descriptive statistics, chi-squares, and linear regressions. Overwhelmingly, participants perceived that premed students experience greater academic stress than their counterparts, yet we found no significant differences in academic stress reported among students in our sample (P > 0.05). Premed students reported that their academic stress was exacerbated by not feeling competitive enough to get into medical school and by needing to maintain a high grade point average (GPA). Furthermore, students with lower GPAs were more likely to leave the premed track compared to those with higher GPAs (P = 0.005). Students reported leaving the premed track because another career appeared more interesting and because of the toll the premed track took on their mental health. In conclusion, our findings can inform instructors and universities on how to best support premed students.