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Background: Anxiety and depression among critical care nurses (CCNs) negatively affect performance because of association with clinical medical errors, ineffective communication, absenteeism from work, and burnout., Objectives: The aim of this study was to investigate the prevalence of anxiety and depression and their associated factors as well as their impact on the CCNs' performance in Hail city, Saudi Arabia., Methods: A cross-sectional correlational study was conducted among 262 CCNs from April to June 2023., Results: The mean scores of anxiety and depression were significantly higher among male and Saudi CCNs than among their counterparts (p < 0.05). CCNs caring for patients in a ratio of 1:5 or more had significantly higher anxiety scores than those with lower nurse-to-patient ratios (p = 0.004). CCNs who were working night shifts had significantly higher mean scores of anxiety (p = 0.005) and lower mean scores of performance (p = 0.041) than their counterparts. Borderline anxiety and depression were prevalent among 43.1% and 38.5% of CCNs, respectively. In contrast, abnormal anxiety and depression were prevalent among 8.8% and 5.7% of CCNs, respectively. CCNs' mental, general, and total performance showed a significant negative correlation with both anxiety ([r = -0.247, p <0.001], [r = -0.183, p = 0.003], and [r = -0.172, p = 0.005], respectively) and depression (r = -0.287, p <0.001), (r = -0.207, p <0.001), and (r = -0.180, p = 0.003), respectively., Conclusions: Anxiety and depression levels are significantly higher among male, Saudi CCNs, higher nurse-to-patient ratios, those who work night shifts than among their counterparts. Less than half of CCNs experience borderline anxiety and/or depression that had significantly negative correlation with their performance. Anxiety and depression in shift nurses may be treated by reducing workload, causes of stress during night shifts, and giving practical coping mechanisms for typical nurse job pressures., (Copyright © 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)