Background: With children today being tested at younger ages, test anxiety has an earlier onset age. There is relatively limited research on test anxiety management programs with elementary school children. The theoretical basis for this nonrandomized pre-post intervention study is grounded in cognitive and behavioral interventions for test anxiety found to be efficacious with children. Objective: The purpose is to examine the impact of a school-based test anxiety prevention program on a sample of Singaporean fourth grade students relative to their levels of academic achievement and to identify active treatment components. Methods: 115 children aged 9-12 were assigned to group-based cognitive-behavioral treatment (n = 58) or control condition (n = 57). They completed the Children's Test Anxiety Scale and Cognitive-Behavioral Skills Checklist at pre-, post-treatment, and 2 months' follow-up. Anxiety ratings were hypothesized to be lower for the intervention than the control group at post-treatment. Skills that contributed to treatment outcomes were identified. Results: A mixed-design analysis of variance revealed significant test anxiety reduction with medium treatment effect that was maintained for the intervention group across time. There was no change in the control group. Behavioral skills (e.g., relaxation exercises, study skills) contributed to treatment outcomes. Cognitive skills such as calming self-talk did not. Conclusions: The study provided preliminary evidence on the utility of brief, school-based anxiety interventions in test anxiety prevention for children. It added credence to adopting behavioral over cognitive strategies in treating test anxious children. Children with severe test anxiety at baseline benefited particularly from treatment.