- Anesthetists’ work carries great responsibility and can be very stressful. Cognitive appraisal plays a central role in stress responses; however, little is known about the relationship between stress appraisal and biological markers of stress, particularly among anesthesiologists. Stress response may be associated with increased levels of systemic cortisol, which can be conveniently measured in saliva and used as a marker for the extent of stress. The objective of this study was to examine the correlation between work-related cognitive variables and waking salivary cortisol, a possible stress marker, in anesthesiologists. Thirty-eight anesthesiologists were assessed for work-related thought intrusions and perceived “mental distance” between themselves and their work, using the pictorial representation of illness self-measure (PRISM), and underwent an implicit association test reflecting implicit job-stress associations. Salivary cortisol was measured twice upon awakening and an hour later, in saliva samples, using a kit based on chemoluminescence competition assay. Only implicit job-stress associations were correlated with waking cortisol (r = 0.35, p < 0.05). Furthermore, high implicit job-stress was related to elevated cortisol only among anesthesiologists reporting large “mental distance” from work, which may represent limited job involvement related to burnout. Anesthesiologists with a low degree of job involvement who have high implicit job-stress associations have higher levels of waking salivary cortisol. Further studies are necessary to assess the impact of stress management techniques on anesthesiologists’ personal and professional behavior as well as on the quality of medical care.