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Background: There is an increasing awareness of the perceived stress and approach to learning effects on academic achievement. Objective: This study aimed to assess the educational environment and approach to learning in clinical phase medical students. Methods: This comparative cross-sectional study was conducted among fifty-nine clinical stage medical students at Omdurman Islamic University (Khartoum, Sudan) during the period from June to August 2016. All the participants signed a written informed consent, then responded to a structured questionnaire to collect demographic data, the two process study questionnaires and the perceived stress questionnaire. The ethical committee of Omdurman Islamic University approved the research, and the Statistical Package for Social Sciences was used to compare the students based on sex, class, and their grades. Data were analyzed by SPSS version 22, using descriptive statistics and t-test. Results: There were fifty-nine medical students, of whom 41.5% were males with a mean age of 22.62±1.84 years. Stress was evident in the majority of medical students (88.1%). The students are using the deep approach to learning more than the superficial approach (The total score was 29.49±6.39 for the deep approach, while it was 20.81±6.94 for the superficial approach). In the current study, no differences were found regarding sex, class, or grades apart from the superficial approach which was used less among women. Conclusion: The perceived stress was prevalent among medical students in Omdurman Islamic University, Sudan, the students used the deep approach to learning more than the superficial, no differences were evident in the perceived stress and the learning approach in relation to sex, class level or grades apart from less superficial approach among women.