Abstract: AIM:To investigate the relationship between T wave alternans and anxiety in patients so as to provide guidance for clinical judgment and intervention. METHODS: One hundred thirty-six patients (59 male and 77 female) undergoing exercise treadmill test from August 2012 to August 2013 at Renmin Hospital of Wuhan University were randomly selected for the study. Standard time domain movement exercise was conducted using Marquetee Microvolt T wave alternans (MTWA) analysis procedure provided by GE Corporation. MTWA values were recorded at V1-V6 leads and the max was recorded as MaxValt. Questionnaire of self-evaluation of anxiety scale (SAS) was performed. RESULTS: Of the 136 patients, 38 were found with anxiety and 98 without anxiety. A significant difference was found in the MTWA index at V3 when the heart rate reached the peak between patients with anxiety and patients without anxiety (P=0.001). CONCLUSION: Results indicate that anxiety to a certain extent affects the MTWA index. Therefore, proper psychological interventional measures undertaken to alleviate patient anxiety will improve the diagnostic accuracy of MTWA, which is of significance in predicting malignant ventricular arrhythmia and sudden death.