Background <p>This study investigates the relationship between gender, smartwatch use, diagnosed health conditions, and health anxiety. Previous research has shown health anxiety is more common among women and those with chronic conditions, but little is known about how these factors interact with the use of wearable health technology.</p> Methods <p>This study employed a cross-sectional design with 259 participants, controlling for age and trait anxiety levels.</p> Results <p>A three-way ANCOVA revealed a significant interaction between gender, smartwatch use, diagnosed health conditions and health anxiety. Post-hoc analysis suggested that smartwatch use is potentially associated with higher health anxiety scores for men with health conditions and this pattern appears to reverse for men without health conditions. In contrast, smartwatch use is potentially associated with lower health anxiety scores for women with health conditions and this pattern appears to reverse for women without health conditions.</p> Conclusions <p>These findings suggest the need for personalised approaches to wearable health technology that consider gender differences and the potential psychological associations. Future research should explore how wearables impact health anxiety across other populations and examine whether different types of smartwatches have distinct effects on health anxiety.</p>