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Stress and anxiety negatively impact the working memory system by competing for executive resources. Broad memory deficits have been reported in individuals with chromosome 22q11.2 deletion syndrome (22q11.2DS). We investigated anxiety and physiological stress reactivity in relation to visuospatial working memory impairments in 20 children with 22q11.2DS and 32 typically developing children (M = 11.10 years, SD = 2.95). Results indicate reduced post-stress RSA recovery and overall increased levels of cortisol in children with 22q11.2DS. Additionally, anxiety mediated the relationship between 22q11.2DS and visuospatial working memory impairment. However, there was no indication that stress response physiology mediated this association. Results suggest that anxiety exacerbates impaired working memory in children with 22q11.2DS. Thus, treatment and intervention methods for children with 22q11.2DS should address anxiety related symptomology.