<p>Earthquakes are among the most frequently observed natural disasters. They have been shown to have impactful consequences on mental health, most commonly post-traumatic stress symptoms. One of the primary features of the latter in the setting of any major trauma, for example, post-earthquakes, is recurrent nightmares, which have been shown to affect psychological well-being. In 2023, a devastating 7.8-magnitude earthquake hit Turkey and affected its neighboring countries, including Lebanon, causing extensive damage and displacement. Therefore, the aim of this study is to understand the mediating role of nightmares distress in the association between PTSD and psychological distress in Lebanese adolescents following the 2023 earthquake. 546 Lebanese adolescents took part in this cross-sectional study. This study was done between February and March 2023 and the data was collected entirely via a Google Form link. They were assessed with self-reported measures using Nightmare Distress Questionnaire-Arabic version (NDQ-AV), The Children’s Impact of Event Scale (CRIES-13) and Depression, Anxiety and Stress Scale-8 items (DASS-8). A mediation analysis was carried out to study the mediation role of nightmares distress in the association between post-traumatic stress symptoms and psychological distress. A greater earthquake impact resulted in increased symptoms severity of nightmares distress (Beta = 0.32). Additionally, nightmares were positively correlated to psychological distress (Beta = 0.23). Furthermore, post-traumatic stress symptoms were directly correlated to psychological distress (Beta = 0.08). According to the mediation analysis, nightmares distress partially mediates the association between post-traumatic stress symptoms and psychological distress. Therefore, the need to implement therapies that targets nightmares is essential in the management of distress following trauma.</p>