<p>Congenital heart disease represents the most common malformation diagnosed in newborns, and the majority, during their lifetime, will have to undergo medical surgery, causing body scars that could impact perceived physical appearance and, subsequentially, their quality of life. In this study, we investigated how anxiety and depression mediate the relationship between perceived physical appearance and quality of life in patients with congenital heart disease. Participants were 708 Italian patients (58.8% male, M_age= 27.03, DS = 7.03. They completed self-report measures assessing perceived physical appearance, anxiety, depression, and quality of life. The results show that perceived physical appearance has a significant, negative, and total effect on quality of life, and even when anxiety and depression are included in the parallel mediation model, perceived physical appearance remains significant. These findings may be important to better understand the mechanism that underlie the relationship between negative self-perception and quality of life, considering the impact of anxiety and depression, particularly among female patients. These results could be used to improve patients’ quality of life and reduce anxiety and depression, enhancing awareness and acceptation of self-body.</p>