To study the burden of anxiety and depression as a comorbid among patients of chronic rheumatological disorders and to investigate possible determinants of depression and anxiety. It was a cross-sectional study conducted at the rheumatology clinic of The Aga Khan University Hospital (AKUH) Karachi, Pakistan. With convenient sampling, 111 patients who fulfilled inclusion/exclusion criteria were screened for anxiety and depression with help of Aga Khan University Anxiety and Depression Scale (AKUADS). The data was entered and analyzed by Statistical Package for Social Sciences (Version 10.0). The population consisted mainly of middle aged (mean age 41) females (80.2%). The most common diagnosis was rheumatoid arthritis 57% followed by systemic lupus erythmatosis 17% and systemic sclerosis 9%. The permanent joint deformity was present in 33.3% patients and 36.9% patients were suffering from active disease with pain and inflammation. The frequency of anxiety and depression was 65.8%. Educational qualification, permanent joint deformity, active inflammation and time elapsed since diagnosis had significant association with anxiety and depression. Marital Status, gender, economic activity and monthly family income had no effect on the frequency of anxiety and depression. Almost two third of patients with chronic rheumatological disorders, also suffered from a concomitant mood disorder. Systematic evaluation of all patients for mood disorders and psychological distress in rheumatology clinics is highly recommended.