So far, three students have committed suicide, overwhelmed by the shame of failure. One male student who had already failed the exam once leapt to his death from a 12-storey hospital in the central city of Guangshui before the test began on Monday. A young woman took her own life in the central city of Ezhou, whilst in the eastern province of Jiangsu, a 21-year-old with a history of mental problems hanged himself with a computer modem line just hours before the exam began.
The two-day exam was staged under tight security to avoid cheating. Roadblocks were set up outside exam venues, and extra police were on hand.
As students feel increasingly under pressure to succeed, they have increasingly turned to high-tech equipment including wireless transmitters and hard-to-detect earpieces
One student suffered a perforated eardrum after he lost a tiny listening device, measuring just 3mm across, inside his ear.
Police have already arrested at least 64 people suspected of selling hi-tech cheating devices.
Some universities have installed cameras and mobile-phone blocking technology inside exam halls to stop people using technology to cheat.
In Beijing on Monday, the authorities even banned nighttime construction projects so as not to disturb students.
Entrance in the more prestigious universities like Tsinghua or Peking University in Beijing or Fudan in Shanghai is seen by many as a passport to secure the family's future.
Those who fail must wait a year before reapplying. This puts them back compared to other members of their age cohort with no guarantees that they will pass the test the next time.
Even as this is happening, unemployment among graduates is rising because of a tightening job market. Government statistics show 87 per cent of college graduates found work last year, and that the available jobs for those who succeed often pay very little.
For this reason, the national college entrance exam is criticised more and more. The one-child policy is partly to blame because it places the hopes and expectations of the whole family on the shoulders of one person.
During exam times, parents often stay with their children in hotels in quiet neighbourhoods, untroubled by traffic, so that students can better focus on their studies.
Many students and parents also visit temples dedicated to Confucius, the site of examinations in imperial times, to burn incense, light candles, make offerings and pray for success. Many will pay a hefty US$ 30 for a tablet on which they write: "Please help my child pass the exam."
Every year, nearly 70 per cent get through, but the disappointment for those who fail can be intense, forced to wait for a year knowing that they can still fail and the prospect of finding a low-level job.
More and more young Chinese are trying to solve this dilemma by studying at foreign universities. Data shows that about 220,000 students went to study overseas in 2009, 50,000 more than in 2008.
This year, 9.57 million students sat for the three-day exam, 650,000 fewer than last year, the second straight year of decline, the Ministry of Education reported. The peak was in 2008, when 10.53 million sat the exam.
For this reason, the more prestigious universities are trying to attract the brightest minds with scholarships. Shanghai's Fudan for example is giving 50,000 yuan to applicants who are in the top five of their provinces.