Objectives <p>The primary aim of this study was to determine the prevalence of mental health symptoms among men and women Australian professional footballers, drawing comparisons with prevalence rates from 2020. A secondary aim was to assess whether mental health symptoms among men and women Australian professional footballers were associated with recent injury and/or psychological resilience. </p> Design <p>Observational cross-sectional study.</p> Methods <p>An electronic anonymous open e-survey.</p> Results <p>86% of A-Leagues players completed the e-survey. In both men and women professional footballers, sport-related psychological distress was common, with prevalence reaching 43% and 66%, respectively. In men football players, injury in the previous 6 months was not associated with mental health symptoms, while psychological resilience was negatively associated with sport-related distress OR 0.947; <i>p</i> = 0.005) and sleep disturbance (OR 0.956; <i>p</i> = 0.027). In women football players, injury in the previous 6 months was associated with problem gambling (OR 3.87; <i>p</i> = 0.035) and alcohol misuse (OR 1.94; <i>p</i> = 0.021), while psychological resilience was negatively associated with global psychological distress (OR 0.92; <i>p</i> = 0.01), anxiety (OR 0.90; <i>p</i> = 0.002), substance misuse (OR 0.88; <i>p</i> = 0.034) and disordered eating (OR 0.95; <i>p</i> = 0.015) but not with other mental health symptoms.</p> Conclusion <p>This population is vulnerable to a range of mental health symptoms. Understanding this may help in the development of policy and emphasizing clinical screening and education of mental health symptoms in football. Musculoskeletal injuries and psychological resilience also affect the prevalence of mental health symptoms.</p>