Objective To study the incidence of moderate and severe preoperative anxiety and its related risk factors in patients undergoing elective general anesthesia.Methods A total of 562 pa-tients undergoing selective anesthesia 225 males and 337 females,aged 18-85 years,ASA physical status Ⅰ-Ⅲ,were selected in the affiliated hospital of Xuzhou medical university.State-trait anxiety inventory (STAI)was used to assess the degree of preoperative anxiety and the patients were divided into mild anxiety group (SAI ≤ 37,n=294)and moderate and severe anxiety group (SAI > 37,n=268)according to SAI score.The factors related to preoperative anxiety such as age,gender,edu-cational background,marital status,history of previous surgery,presence of pain,preoperative diag-nosis of tumor and presence or absence of hypertension were collected.Results The incidence of moderate and severe preoperative anxiety in our study was 268 (47.7%).Logistic regression analysis showed that female (OR=1.846,95%C I 1.298-2.624),single (OR=2.208,95%C I 1.218-4.004) might be the risk factors of preoperative anxiety.Conclusion Females and single individuals may be independent risk factors for preoperative anxiety.