Purpose <p>There is a need for non-pharmacological interventions in the management of physical and psychological symptoms associated with chemotherapy. This study was conducted to determine the effect of music and affirmation listening on symptom management, psychological resilience, and anxiety levels in women with breast cancer.</p> Methods <p>The sample of this randomized controlled study consisted of 71 women with breast cancer receiving chemotherapy at a training and research hospital. The data were collected using the Descriptive Information Form, the Edmonton Symptom Assessment Scale, the Psychological Resilience Scale, and the Beck Anxiety Inventory. Women in the music group listened to Neva mode and pentatonic music, while patients in the music and affirmation group listened to the same music along with affirmation audio recordings. Study data were collected at three time points: before the intervention, 1&#xa0;week later, and 1&#xa0;month later.</p> Results <p>The changes over time in the mean scores of pain, nausea, appetite, and dyspnea were found to be similar across all three groups (<i>p</i> &gt; 0.05). The post-test mean scores for well-being, depression, and drowsiness symptoms in the control group were found to be significantly higher than those in the music group and the music and affirmation group (<i>p</i> &lt; 0.05). In the comparison of Beck Anxiety Inventory scores, no statistically significant interaction effect was found; however, the differences in the marginal means across the three time points were statistically significant (<i>p</i> &lt; 0.05). The changes over time in the mean scores of psychological resilience were found to be similar across all three groups (<i>p</i> &gt; 0.05).</p> Conclusions <p>Music and affirmation may help alleviate well-being, depression, and drowsiness symptoms in women with breast cancer undergoing chemotherapy. The inclusion of non-pharmacological methods in care is important. Simple, non-pharmacological methods such as music and affirmations can be used in patient care practices during the chemotherapy process.</p> Trial registration <p><i>Clinical Trails.gov</i> (Registration number: NCT06713408. registered on 27 November 2024).</p>