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Background/Objectives: Hwa-byung (HB), traditionally observed in middle-aged Korean women, was investigated among the MZ generation in Republic of Korea to investigate its prevalence, associated factors, and perceptions. Methods: An online survey was conducted with 449 Korean adults in the Republic of Korea born between 1980 and 2005. The participants completed questionnaires that assessed HB symptoms, emotional labor, psychological distress, and HB perceptions. Data were analyzed using Chi-squared tests, t-tests, and bivariate logistic regression. Results: The prevalence of HB in the MZ generation was 36.3%. Significant HB predictors included female sex (odds ratio [OR] = 2.314), poor subjective health (OR = 3.207), higher HB trait scores (OR = 1.155), depression (OR = 1.145), and state anger (OR = 1.087). Only 44.54% of the participants were aware that HB is a diagnosed mental disorder and 34.97% knew that it could be treated at traditional Korean medicine (TKM) clinics. Despite the limited awareness, 49% expressed interest in TKM treatment for HB, in which acupuncture, herbal medicine, and mind–body medicine are the preferred modalities. Conclusions: This study revealed a high HB prevalence among the MZ generation in the Republic of Korea, which challenges traditional perceptions of this syndrome. These findings highlight the need to reevaluate HB conceptualization and treatment approaches for younger generations. Future research should focus on longitudinal studies, qualitative investigations of the evolving HB cultural context, and the development of targeted awareness and intervention programs to address this significant mental health issue in contemporary Korean society. [ABSTRACT FROM AUTHOR]