Objective To evaluate the anxiety or depression of patients with primary hemifacial spasm (HFS) and to explore the association between the disease state and psychological condition of patients with HFS.Methods The clinical data of 120 HFS patients, who visited the Botulinum Clinic of Xiangya Hospital of Central South University between 2013 and 2015, were collected in this study. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to test all patients. Statistical analysis was performed using SPSS version 17.0 for the association.Results Our results showed that the mean SAS and SDS standard scores of female patients were higher than those of the male patients, although the differences were not statistically significant (P>0.05). Of all female patients, 11.4% suffered from anxiety, and 15.4% suffered from depression; these were more prevalent in female patients than in male patients, but the differences between the two gender groups were not significant (P>0.05). Additionally, the mean SAS and SDS standard scores were significantly higher in HFS patients with a duration of 10 years or longer than in those with a duration shorter than 10 years (P<0.05). Patients with high intensity and degree of spasm had significantly higher SAS and SDS standard scores than those with medium or low intensity and degree of spasm (P<0.05). The logistic multivariate regression analyses confirmed that the length of HFS duration and the intensity and degree of spasm were risk factors for anxiety and depression in HFS patients.Conclusions Compared with healthy people, HFS patients are more likely to experience anxiety and depression, which are positively associated with the duration of disease and the intensity and degree of spasm, but are not associated with gender.