<p>Mastalgia is a common complaint in women. Mastalgia can be caused by benign or malign diseases. Also, mastalgia can be categorized as cyclic or non-cyclic depending on its relationship with the menstrual cycle. The purpose of this study is to evaluate the diagnosis, quality of life, anxiety and depression levels in women in the age group of 20 to 45 years with symptoms of mastalgia. This cross-sectional observational study involved 100 women aged 20–45 years presenting with symptoms of mastalgia. Participants were selected based on the inclusion and exclusion criteria, following approval from the institutional ethics committee. Pain was assessed using the Visual Analogue Scale (VAS), health-related quality of life was evaluated using the WHOQOL-BREF (Tamil version), and levels of anxiety and depression were measured using the Hospital Anxiety and Depression (HAD) scale. Among 100 women with mastalgia, 82 had a history of analgesic use—mostly paracetamol (52), followed by NSAIDs (18) and NSAID gels (12)—with 52 showing analgesic dependency. All were non-smokers. Fibroadenosis (45%) was the most common diagnosis, followed by fibroadenoma (15%), mastitis (9%), breast abscess (5%), duct ectasia (3%), galactocoele (2%), and non-specific pathology (19%). VAS scores showed most had mild (65%) or moderate (23%) pain. HADS revealed mild anxiety in 60%, moderate in 29%, and severe in 11%. WHOQOL-BREF indicated a moderate quality of life in 59%, high in 30%, and low in 11%. Mastalgia, though commonly benign, significantly impacts the physical and psychological well-being of women. A considerable proportion also exhibited varying degrees of anxiety and a moderate quality of life, highlighting the multifactorial nature of mastalgia. These findings underscore the importance of a holistic approach in evaluating mastalgia—addressing not only the underlying pathology but also the psychological and quality-of-life aspects to ensure comprehensive patient care. </p>