Abstract: Severity of anxiety and depression in patients with rheumatism is obviously greater than that in patients with other internal diseases. Intestinal flora imbalance may lead to a variety of autoimmune diseases. The imbalance of intestinal flora can affect the bi-directional communication between mucosal immune system and gut-brain axis. Therefore, anxiety and depression of patients with rheumatism are also closely related to the imbalance of intestinal flora, which are mainly manifested in the following three aspects: the influence of intestinal flora and intestinal peptide on the bi-directional communication of gut-brain axis, the relationship between intestinal autonomic nerve and vagus nerve and central nervous system, and the relationship between intestinal flora imbalance and autoimmunity. Based on the analysis in the above factors, the imbalance of intestinal flora has a negative superimposed effect on anxiety and depression in patients with rheumatism.