<p>Black children are at significant risk for anxiety through heightened exposure to poverty, trauma, and racial discrimination, and females are at higher risk for childhood onset than males. One potentially relevant factor is difficulties with worry regulation. This study seeks to understand how difficulties with worry regulation and sex differences may affect risk for anxiety in Black children. The present study examined relations between difficulties with worry regulation and anxiety symptoms by sex in a sample of 98 Black children (M_age = 10.08, SD_age = 1.48). Caregivers reported on child worry dysregulation (i.e exaggerated displays of worry), worry inhibition (i.e suppression of worry), and anxiety. Positive associations were found between caregiver-reported child worry dysregulation and anxiety symptoms (<i>r</i> = 0.41<i>, p</i> &lt; 0.01) but not worry inhibition (<i>r</i> = 0.11<i>, p</i> = 0.37). The association between higher child worry dysregulation and higher child anxiety symptoms was moderated by child sex, (<i>B</i> = 5.00, <i>p</i> = 0.01), such that it was significant in girls but not in boys, independent of child trauma exposure and pubertal acceleration. Higher worry dysregulation was related to higher anxiety in girls but not boys. Trauma exposure also predicted higher child anxiety symptoms (<i>p</i> &lt; 0.01). Worry dysregulation may be a helpful target for identifying girls at risk for anxiety disorders. Future research should examine additional factors that may relate to anxiety symptoms in Black male children, including other facets of emotion dysregulation, to further disentangle sex specific pathways of risk.</p>