OBJECTIVE: The purpose of this retrospective, case-control study is to examine the medical and productivity costs for individuals who have been diagnosed with anxiety. METHODS: This study uses an employer database that collected medical, absenteeism, short-term disability, and worker compensation records during 1999 from 6 major employers. Patient diagnosed with anxiety disorder (based on ICD-9 codes of 300.0, 300.00, 300.01, 300.02 or 300.21) (N=601) were matched at a 1:2 ratio to patients not diagnosed with anxiety disorder (N=1202) based upon age, sex, and metropolitan statistical area. Chi-square and t-statistics were used to compare the anxiety population to the control group. RESULTS: Employees diagnosed with anxiety disorder are significantly more likely to have additional diagnoses, use more medical and psychiatric services and are more likely to be hospitalized or visit the emergency room compared to the control group. Furthermore, employees diagnosed with anxiety disorder have significantly higher medical costs ($5447 vs. $2344; p<0.0001), productivity costs ($2366 vs. $1438; p<0.0001) and total costs ($7813 vs. $3782; p<0.0001) compared to the control group. CONCLUSION: Results indicate employed individuals diagnosed with anxiety disorder have significantly higher medical and productivity costs. Further examination of costs attributed to anxiety disorder and those resulting from comorbidities is warranted.