<p>The first signs of aging, such as changes in appearance or physical capacity, often appear in middle adulthood and may lead to aging anxiety. Women experience greater pressure around their looks, and they might feel stronger aging anxiety if their self-worth is tied to their appearance and they have low appearance satisfaction. Conversely, an accepting, self-compassionate attitude may be related to lower levels of appearance-contingent self-worth, higher appearance satisfaction, and, in turn, lower aging anxiety. This study aimed to investigate the associations between aging anxiety and self-compassion in women in middle adulthood, which we broadly defined as the period between young adulthood and older age, and to examine mediating roles of appearance contingent self-worth and higher appearance satisfaction in this relationship. This cross-sectional study’s sample was 1023 Lithuanian women between 30 and 59 years of age (<i>M</i> = 44.96, <i>SD</i> = 8.22). The findings revealed that both appearance-related aging anxiety and general aging anxiety were related to self-compassion, appearance contingent self-worth, and appearance satisfaction. Self-compassion had a direct relationship to aging anxiety and an indirect relationship mediated through appearance contingent self-worth and appearance satisfaction. These findings highlight the importance of self-compassion in middle adulthood and women’s relationship to their appearance as potential ways to negate aging anxiety.</p>