Objective To explore the relationships of self-esteem, implicit self-esteem and perfectionism in the depressed patients. Methods Both of the depression group (n=50) and control group (n=45) completed the self-esteem scale (SES), the self-acceptance questionnaire (SAQ), the Chinese Frost multidimensional perfectionism scale (CFMPS), the implicit association test and the Raven’s Standard Progressive Matrices. The implicit association test were performed before (pre-IAT) and after (later-IAT) the Raven’s Standard Progressive Matrices. Results The SES score was lower in depression group than in control group (P=0.002). To the IAT score, the interaction effect of group and time achieved no statistically different (P=0.735). The group main effect of IAT was significant (P=0.001). The IAT score was higher in de?pression group than in control group (P=0.013). The time main effect was significant (P=0.033). The pre-IAT was higher than later-IAT (P=0.007). The depression group had higher scores of concern over mistakes (P=0.007) and doubt about action (P=0.006) dimension of CFMPS, and lower score of parental expectations (P=0.038) dimension than the control group. The later-IAT was negatively related with parental expectations dimension and the total score of CFMPS in the de?pression group (P<0.05). Depressed patients’SES and SAQ scores were negatively related with concern over mistakes and doubt about action dimension and the total score of CFMPS (P<0.05). Conclusion The instability of implicit self-es?teem of depressed patients is associated with negative perfectionism.