Music performance anxiety (MPA) affects amateurs, students and professional musicians. We aimed to analyse MPA among students of music performance in a higher education academy in Lithuania. A sample of 258 music performance arts students of the Lithuanian Music and Theatre Academy participated in this study. The Kenny Music Performance Anxiety Inventory (K-MPAI) was used for assessment of MPA. High MPA was associated with less concert activity, poorer perceived performance self-efficacy, and lower academic achievement grades. We did not find gender effects on MPA. Results revealed that 20.2% of the students reported difficulties in coping with MPA. Our findings inform music educators about the need to address MPA and coping with MPA in the process of teaching.