Background: Stress is ubiquitous and is an inseparable part of various activities. Stress toward dental procedures is widely prevalent among dental patients, especially among those undergoing dental extractions. There are very few studies reported in the literature which explore various aspects related to stress among patients during dental extractions. Aim and Objectives: To determine levels and perceived sources of stress during dental extraction appointments among patients seeking care at one of the private University hospitals in Riyadh, Saudi Arabia. Materials and Methods: Patients undergoing dental extraction in the outpatient clinics of college of dentistry Riyadh Elm University hospital were invited to participate in the study. Oral Maxillofacial residents performed the extraction procedure. Blood pressure, pulse rate, and temperature were recorded by using blood pressure, pulse rate monitor, and infrared thermometer for body temperature. Results: Systolic blood pressure was significantly raised during the step of forceps extraction than any other stage. Pulse rate was significantly higher at luxation (M=85.41, SD=14.38) than during the forceps extraction (M=70.03, SD=38.14); t(31)= 2.435, p=0.021. Mean systolic BP during forceps extraction was found to be significantly higher among the group reporting previous bad extraction experience. Conclusion: Blood pressure was significantly higher during forceps extraction than any other stage, including the luxation step. The pulse rate was significantly higher at luxation than during the forceps extraction. Previous bad experience had a significant impact on blood pressure levels during forceps extraction. Clinicians should be sensitized towards patients' experience in managing stress during dental extraction procedures.