Background and aims <p>Crohn’s disease is a chronic inflammatory condition often requiring surgical intervention, which can significantly impact a patient’s quality of life and mental health. This study aimed to evaluate the prevalence of anxiety and depressive symptoms in surgically treated patients with Crohn’s disease.</p> Methods <p>A comparative cross-sectional study at a tertiary center included surgically and non-surgically treated patients with Crohn’s disease. Anxiety and depressive symptoms were assessed using the Generalized Anxiety Disorder-7 questionnaire and Patient Health Questionnaire-9. Disease activity was assessed using Harvey Bradshaw index and endoscopic recurrence was evaluated using the Rutgeerts score.</p> Results <p>A total of 97 patients with Crohn’s disease (54 surgical, 43 non-surgical controls) were included. The prevalence of anxiety and depressive symptoms were comparable between groups (57.4% surgical vs. 60.5% controls, <i>p</i> = 0.330) and (70.4% vs. 79.1%, <i>p</i> = 0.761), respectively. Surgical group had significantly better depression severity outcomes, with lower median Patient Health Questionnaire-9 scores (6.0 vs. 9.0, <i>p</i> = 0.007) and no cases of severe depression (0% vs. 14%, <i>p</i> = 0.025). Active disease was significantly associated with anxiety and depressive symptoms, whereas a lower body mass index was significantly associated with symptoms of depression.</p> Conclusion <p>Previous surgery was not associated with lower prevalence of symptoms of anxiety or depression but was associated with significantly milder depression severity. The strong association of active disease and anxiety symptoms, and of active disease and lower body mass index with depressive symptoms, highlights the need for comprehensive care models that target both physical and psychological symptoms.</p>