Abstract Body (Do not enter title and authors here): Pulmonary embolism (PE) is the third leading cause of cardiovascular death. It has been shown to be accompanied by significant psychological distress. The prevalence and longitudinal trends of anxiety and depression in PE patients largely remains unknown. We conducted a prospective observational study examining 188 PE patients attending a dedicated Pulmonary Embolism Response Team (PERT) Clinic. Participants completed standardized assessments using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) to measure anxiety and depression, respectively, following their PE diagnosis and ensuing treatment. Our findings revealed noteworthy gender disparities in the psychological impact of PE on survivors. Among women, 41% reported anxiety and 44% reported depression. Among men, 17% reported anxiety and 20% reported depression. Women more likely to experience depression post-PE and were twice as likely than men to experience anxiety. Furthermore, regardless of gender, we observed a decrease in the prevalence of anxiety and depression over time from the date of initial diagnosis. Younger patients exhibited higher levels of anxiety and depression compared to older counterparts. Additionally, patients with recurrent PE had higher levels of anxiety and depression compared to those with a single thrombotic episode. This study represents the largest dedicated prospective study to date to examine the psychological impact of PE on patients' psyche. It underscores the significant psychological toll of PE on patients' recovery. We noted women experienced higher rates of anxiety and depression compared to men. Younger patients and those were recurrent PE were more likely to experience psychological distress. Regardless of age and sex, the prevalence of anxiety and depression decreased with time. These findings highlight the importance of tailored psychosocial support strategies to address the unique emotional needs of patients following a PE diagnosis. Disparities in anxiety and depression prevalence following PE diagnosis and treatment exist. This study highlights the importance of implementing tailored psychosocial support strategies to address the unique emotional needs of PE patients, particularly among women, younger patients, and those with recurrent PE.