This study examined occupational stress, its related symptoms, associated factors, and coping strategies among heads of secondary schools in Kohat Division, Pakistan. A sample of 101 secondary school-heads was taken using a multistage sampling technique. Occupational Stress Index (Shrivastava & Singh, 1981) followed by four open-ended questions was used to investigate the study variables. Findings revealed that heads of secondary schools were occupationally stressed in their workplace. The most associated factors causing occupational stress were poor compensation, work overload, lack of effective advancement and promotion policy, poor implementation of education policy, lack of basic facilities, political interference, and under-participation. Several symptoms such as headaches, alterations in blood pressure, and digestive problems, were found to be associated with an increased risk of occupational stress. Furthermore, various related perceived physiological, psychological, and behavioral consequences were found to be caused by stress at work. Findings suggest that a comprehensive strategy promoted by the education department should be recommended for reducing stress among secondary school-heads and improving their wellbeing and other health_x0002_related conditions at the workplace.