Objective To investigate the prevalence and influencing factors of depressive disorder and anxiety in hospitalized patients with tuberculosis， so as to provide a basis for implementing comprehensive psychosocial support interventions in clinical practice. Methods Using the cross-sectional study design， 247 hospitalized patients from the Department of Tuberculosis of Beijing Chest Hospital， affiliated with Capital Medical University， were conveniently selected as study subjects between January 20 and February 15， 2026. Patients' socio-demographic and clinical baseline information were collected using the General Information Questionnaire， and the severity of depression and anxiety was assessed using the Patient Health Questionnaire-9（ PHQ-9） and Generalized Anxiety Disorder-7（ GAD-7）， respectively. Multivariate Logistic regression analysis was used to explore the influencing factors of depressive disorder and anxiety in hospitalized patients. Results A total of 247 questionnaires were distributed， with 196 valid responses， resulting in a valid response rate of 79.4%. The prevalence of depressive disorder（ PHQ-9 total score ≥5） among 196 hospitalized tuberculosis patients was 48.5%（ 95/196）， the prevalence of anxiety（ GAD-7 total score≥5） was 31.6%（ 62/196）， and the prevalence of comorbid depressive disorder and anxiety（ PHQ-9 total score ≥5 and GAD-7 total score ≥5） was 28.6%（ 56/196）. Univariate analysis showed that there were significant differences in the prevalence of depressive disorder among hospitalized tuberculosis patients with different family size， chronic disease， age， body mass index（ BMI） and use of Bedaquiline（ χ2/Z=8.557， 2.421，-2.014， -2.967，7.463； all P ＜ 0.2）. There were statistically significant differences in the prevalence of anxiety among hospitalized tuberculosis patients with different family size， drug resistance， use of Bedaquiline and age（ χ2/Z=3.908， 3.839， 1.807， -2.419； all P＜ 0.2）. After adjusting for confounding factors， multivariate Logistic regression analysis showed that high BMI［ OR=0.905， 95%CI（ 0.831， 0.984）， P=0.020］ and large family size［ OR=0.140， 95%CI（ 0.037， 0.529）， P=0.004］ were independent protective factors for depressive disorder in hospitalized patients with tuberculosis. Advanced age［ OR=0.976， 95%CI（ 0.957， 0.995）， P=0.013］ and larger family size［ OR=0.299， 95%CI（ 0.101， 0.889）， P=0.030］ were independent protective factors for anxiety in hospitalized patients with tuberculosis. Conclusions Hospitalized tuberculosis patients have a high incidence of depressive disorder， anxiety， and emotional comorbidity， and psychological issues are relatively common. High BMI and large family size are independent protective factors of depressive disorder in patients， while advanced age and family size are independent protective factors of anxiety. Clinical attention should be focused on hospitalized tuberculosis patients with low BMI， young age and small family size， and targeted psychological intervention should be carried out to effectively alleviate the negative emotions of patients and promote the recovery of the disease.