<p>Burning Mouth Syndrome (BMS) is a complex symptomatology potentially influenced by Traditional Chinese Medicine (TCM) syndromes, emotional states, and immune function. The aim of the present study is to explore the complex relationships of TCM syndrome types, emotion and immune function, in patients with BMS , using a cross-sectional design. A total of 153 BMS patients were categorized into excess patterns (hyperactive heart fire type and liver-gallbladder damp-heat type) and deficient patterns (liver-kidney yin deficiency type and qi deficiency with blood stasis type). We analyzed correlations between TCM syndrome types and clinical parameters, including immune function, anxiety, and depression. Assessment tools included humoral immunity, lymphocyte subsets, and Hamilton, BDI, HAMA, and SAS scales. the hyperactive heart fire type is most prevalent among BMS patients. Patients with excess patterns, particularly hyperactive heart fire, and liver-gallbladder damp-heat types, exhibited significantly higher levels of anxiety and depression compared to deficient patterns types. Immune analysis showed that C3 levels were notably higher in excess patterns patients, The IgG levels is lower in excess patterns patients. Additionally, anxiety and depression were linked with lower levels of IgG 、C3、IgA and CD3+, respectively. Dry mouth was more common in the hyperactive heart fire type, and patients with excess patterns had poorer sleep quality. The severity of anxiety and depression was positively correlated with pain VAS scores. This study found associations between TCM syndromes, emotional disturbances, and immune function in patients with BMS, with notable patterns observed in those classified with hyperactive heart fire.</p>