| Objective To explore the effects of anxiety and depression on Internet gaming disorder symptoms in medical students, and the regulatory effect of gender among them, so as to provide reference for the prevention and intervention of medical students' Internet gaming disorder. Methods In November 2021, 11 771 medical students in Sichuan Province were surveyed using the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and The nine-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF), which were use multiple hierarchical regression to analyze the regulatory role of gender in the relationship between anxiety, depression and symptoms of Internet gaming disorder. Results ①Male medical students had lower SDS scores than female medical students(t=-8.302, P<0.01), male medical students had higher IGDS9-SF scores than female medical students(t=33.384, P<0.01). ②The SAS score of medical students was positively correlated with the SDS score(r=0.735, P<0.01), the SAS score, SDS score and IGDS9-SF score of medical students were positively correlated(r=0.288, 0.238, P<0.01). ③Anxiety and depression can positively predict symptoms of Internet gaming disorder(β=0.245, 0.058, t=18.864, 4.444, P<0.01). ④Gender had a regulatory effect between anxiety and symptoms of Internet gaming disorder(β=-0.194, t=-4.518, P<0.01). Conclusion Anxiety and depression have a positive predictive effect on symptoms of Internet gaming disorder in medical students. The effects of anxiety on symptoms of Internet gaming disorder are regulated by gender, compared with female medical students, male medical students' anxiety has a stronger positive predictive effect on symptoms of Internet gaming disorder.