<p>This qualitative study aimed to investigate the challenges, coping strategies, and mental health experiences of individuals living with ankylosing spondylitis in Hong Kong. Semi-structured interviews were conducted with a purposive sample of 15 diagnosed individuals from May to July 2024, and thematic analysis was used to interpret the data. The analysis revealed five main themes: physical and psychosocial challenges, cognitive assessment and personal perceptions, behavioral coping strategies, emotional responses to ankylosing spondylitis, and expectations for the future. Participants reported significant difficulties in daily life and mental health, and utilized a range of coping strategies that resulted in both positive and negative outcomes. This study provided new insights into the lived experiences of individuals with ankylosing spondylitis, highlighting the importance of effective coping mechanisms and raising societal awareness, and suggesting directions for future interventions to enhance mental well-being and support for this population.</p>