Quantum periods appear in many contexts, from quantum mechanics to local mirror symmetry. They can be described in terms of topological string free energies and Wilson loops, in the so-called Nekrasov-Shatashvili limit. We consider the trans-series extension of the holomorphic anomaly equations satisfied by these quantities, and we obtain exact multi-instanton solutions for these trans-series. Building on this result, we propose a unified perspective on the resurgent structure of quantum periods. We show for example that the Delabaere-Pham formula, which was originally obtained in quantum mechanical examples, is a generic feature of quantum periods. We illustrate our general results with explicit calculations for the double-well in quantum mechanics, and for the quantum mirror curve of local P².