Objective To investigate the clinical characteristics and associated factors of suicide risk and anxiety symptoms in late-life depression（ LLD） patients at the acute phase. Methods A cross-sectional observational study was conducted to analyze data of 117 LLD patients accompanied by suicide risk and anxiety symptoms hospitalized at Beijing Anding Hospital affiliated with Capital Medical University between July 2021 and May 2022. This study collected patients' general information， clinical characteristics， cognitive function， five thyroid function parameters， adrenocorticotropic hormone， cortisol， total cholesterol， triglycerides， highdensity lipoprotein cholesterol， low-density lipoprotein cholesterol， and sex hormone levels. Hamilton Anxiety Rating Scale（ HAMA）， Hamilton Depression Rating Scale-24（ HAMD-24）， and Montreal Cognitive Assessment （MoCA） were used to evaluate anxiety， depressive symptoms， and cognitive function. According to the total score of HAMA， patients were divided into mild anxiety group（ HAMA score 14-＜21， n=47） and moderate to severe anxiety group（ HAMA score≥21， n=70）. Clinical symptoms， cognitive function， and endocrine hormone levels were compared between the two groups. Logistic regression was used to analyze risk factors for moderate-tosevere anxiety symptoms. Results Compared with patients with mild anxiety， those with moderate to severe anxiety had a higher proportion of married individuals［ 84.29%（59/70） vs. 68.09%（32/47），χ2=4.270］ and a higher proportion of prior history of traumatic brain injury［ 22.86%（16/70） vs. 6.38%（3/47）， χ2=5.611］， higher scores on the HAMD anxiety/ somatization factor［ 9.00（ 7.00，11.00） vs. 8.00（ 6.00，9.00）， Z=-3.259］， and sleep disturbance factor［ 6.00（ 4.75，7.25） vs. 6.00（ 3.00，6.00）， Z=-2.182］， and higher total HAMD-24 scores ［30.00（ 27.00，37.25） vs. 27.00（ 24.00，30.00），Z=-4.058］， and higher scores on the HAMA psychotic anxiety factor［ 14.00（ 12.75， 17.00） vs. 11.00（ 10.00，12.00）， Z=-6.687］ and somatic anxiety factor［ 17.00（ 15.00， 20.00） vs. 13.00（ 12.00，14.00），Z=-6.352］， and lower MoCA total scores［ （17.51±4.80） vs.（ 20.10±4.67） t=2.249］， and all differences were statistically significant（ all P＜0.05）. Logistic regression analysis revealed that the anxiety/somatization factor was a statistically significant risk factor of moderate-to-severe anxiety in LLD patients with suicide risk［ OR=1.636，95%CI（ 1.030，2.599），P=0.037］. Conclusions Among LLD patients with suicide risk and anxiety symptoms at the acute phase， those with moderate to severe anxiety are often married， have a history of traumatic brain injury， have severe depressive symptoms， and low cognitive function. The anxiety/somatization factor is a risk factor for moderate to severe anxiety symptoms.