Public speaking anxiety is a prevalent phenomenon experienced by university students, particularly during formal academic presentations that involve evaluative pressure from lecturers and the demands of academic performance. This study aims to analyze the factors contributing to public speaking anxiety among university students in formal academic presentation contexts and to describe the coping strategies they employ to manage such anxiety. A qualitative approach with library research design was applied, utilizing content analysis of scientific literature including journals, books, theses, and proceedings published between 2021 and 2026. Data were analyzed using an interactive analysis model through the stages of data reduction, data display, and conclusion drawing, with source triangulation applied to ensure the validity of findings. The results indicate that public speaking anxiety in academic presentations is shaped by two interrelated dimensions: internal factors including low self-confidence, negative self-talk, self-efficacy deficits, and physiological symptoms such as rapid heartbeat and trembling and external factors, comprising evaluative pressure from lecturers, unexpected questions from peers, and inadequate preparation due to academic procrastination. Students manage this anxiety through a combination of problem-focused coping strategies (comprehensive material preparation and structured public speaking training) and emotion-focused coping strategies (positive affirmations, deep breathing techniques, and peer social support). The findings underscore that neither approach is sufficient in isolation; an integrated combination of adaptive emotion regulation, structured training, and thorough material preparation constitutes the key to successful anxiety management in formal academic settings.