Effects of item arrangement (easy-hard, uniform, and random), test anxiety, and sex on a 48-item multiple-choice mathematics test assembled from items of the American College Testing Program and taken by motivated upper level undergraduates and beginning graduate students were investigated. Four measures of anxiety were used: the Achievement Test Anxiety Scale, STAI-STATE and STAI-TRAIT of Speilberger's State Trait Anxiety Inventory and the Mathematics Anxiety Rating Scale. Significant (P=less than .05) sex, anxiety, and sex by order effects were found for the cognitive variable with males outperforming females, low anxious students scoring higher than anxious ones, and males with easy-hard ordering scoring substantially better than females with the same order of items. Significant anxiety, sex, and order effects were found for the perception scores of perceived difficulty and performance. The fact that males outperformed females on a mathematics test with items arranged easy-hard suggests that item arrangement may be another possible explanation for observed sex differences in mathematics achievement at the college level. (Author/RL)