<p>The widespread use of thoracic imaging has led to an increase in the detection of incidental pulmonary nodules. Although the majority of incidental pulmonary nodules are benign, their detection may trigger psychological symptoms, including anxiety and depression, driven by fear of malignancy. This study aimed to assess the prevalence of elevated anxiety and depression symptoms among patients with incidentally detected pulmonary nodules and to explore associated demographic and clinical factors.</p><p> In this cross-sectional study, 95 patients with incidentally detected pulmonary nodules were enrolled. Anxiety and depression symptoms were evaluated using validated psychometric scales. Logistic regression analysis was performed to identify independent predictors of elevated anxiety and depression scores.</p><p>Elevated anxiety symptoms were observed in 41.1% of the patients, and elevated depression symptoms in 40.0%. Female sex (<i>p</i> = 0.028), smoking history (<i>p</i> = 0.045), and undergoing positron emission tomography imaging (<i>p</i> = 0.024) were significantly associated with higher anxiety scores. Female sex was also associated with higher depression scores (<i>p</i> = 0.043). Multivariate analysis identified positron emission tomography imaging as an independent predictor of elevated anxiety symptoms (odds ratio, 4.533; <i>p</i> = 0.040).</p><p>In conclusion, elevated anxiety and depression symptoms are common among patients with incidentally detected pulmonary nodules. Incorporating psychological screening into the routine evaluation of these patients may enhance comprehensive clinical management.</p>