BACKGROUND Anxiety and depressive symptoms are common worldwide and, according to the World Health Organization, their prevalence has increased in the last decades. Further, dysfunctional personality traits are frequently coupled with anxiety and depressive symptoms. The prevalence of these symptoms is particularly relevant in medical students. METHODS This study assessed the prevalence of anxiety and depressive symptoms in Italian medical students from the University of Modena and Reggio Emilia, by using the Hospital Anxiety and Depression Scale (HADS). Personality traits were assessed as well by employing the Personality Inventory for DSM-5, Brief Form (PID-5-BF), to explore their association with anxiety and depressive symptoms. A self-administered questionnaire was sent by e-mail to all the 944 students and 459 (48.6%) were enrolled. Besides the HADS and the PID-5-BF, the questionnaire included items concerning everyday life activities such as sports and academic features such as the years of attendance and average marks. RESULTS A high prevalence of anxiety (n=92; 20%), depression (n=32; 7%), and comorbid anxiety-depressive symptoms (n=218; 47%) was reported. Multiple binary logistic analysis showed increased levels of anxiety and depression to be associated with personality traits, namely detachment and negative affect, and use of cognitive enhancers. On the other hand, sports activities, social activities and distraction were related to lower levels of symptoms. CONCLUSIONS Symptoms of depression and anxiety are common among Italian medical students and specific interventions should be implemented to target them.