Objective <p>This study aims to investigate the correlation between alexithymia and resilience levels in young breast cancer patients after undergoing modified radical mastectomy.</p> Methods <p>A prospective study was conducted on 70 young breast cancer patients, who were categorized based on the Toronto Alexithymia Scale-20 (TAS-20) scores into: non-alexithymia group (<i>n</i> = 24); moderate alexithymia group (<i>n</i> = 32); and severe alexithymia group (<i>n</i> = 14). The Toronto Alexithymia Scale-20 (TAS-20) and the Connor-Davidson Resilience Scale (CD-RISC) were utilized for evaluation to analyze the relationship between alexithymia and resilience levels post-modified radical mastectomy.</p> Results <p>In this study, the CD-RISC scores for the non-alexithymia group were 85.32 ± 7.65, for the moderate alexithymia group were 72.45 ± 8.32, and for the severe alexithymia group were 58.96 ± 9.13. The differences in CD-RISC scores among the three groups were statistically significant (<i>P</i> &lt; 0.001), with the scores decreasing from the non-alexithymia group to the moderate and then to the severe group. Correlation analysis showed a negative correlation between the total and dimensional scores of TAS-20 and the total and dimensional scores of CD-RISC (-0.667 &lt; <i>r</i>&lt;-0.200, <i>P</i> &lt; 0.05).</p> Conclusion <p>Young breast cancer patients exhibit a moderate level of alexithymia post-modified radical mastectomy, which negatively correlates with their level of psychological resilience. Clinically, appropriate intervention measures can be implemented based on the patients’ conditions to enhance their psychological resilience and alleviate alexithymia.</p>