This study investigated the impact of 26 EFL college students’ familiarity levels with the visual information of TOEIC listening test items on test scores and test performance procedure. Data collected measured students’ degree of familiarity with the visuals via a pre-test and their listening test scores, and responses to the post-test questionnaire were analyzed. To analyze the data, one-way ANOVA was conducted to locate the interdependency between the students’ familiarity levels with visuals and their test scores. Results found that there was no statistically significant differences in test scores regardless of the students’ levels of familiarity with the visuals. Additionally, the correlations between the familiarity with the visuals and the students’ test scores were low. However, the students experienced difficulties with unfamiliar visuals while taking the test. These findings indicate that, although test-takers’ familiarity with visuals does not predict their listening test scores, there is a need to tailor the visuals when developing listening test-items.