Objective To understand the correlation among anxiety, depression, and OPRM1 gene polymorphism in elderly Uygur women with pain in Xinjiang and to provide theoretical evidence for the treatment of elderly Uygur women with pain in Xinjiang. Methods The random number table sampling method was used to select female outpatients aged 65‒80 years. The Numerical Rating Scale (NRS) was used to evaluate the pain degree of patients (patients with NRS score≥1 were defined as pain patients). A total of 1 012 patients with pain at various degrees were included. The Self‑Rating Anxiety Scale (SAS) and Self‑Rating Depression Scale (SDS) were used to assess the anxiety and depression of patients. According to SAS score and SDS score, the patients were divided into two groups: an anxiety group, a non‑anxiety group, a depression group and a non‑depression group. The polymorphism of the OPRM1 gene was detected by polymerase chain reaction‑restriction fragment length polymorphism (PCR‑RFLP), and its allele and genotype distribution frequency was counted. An electrical stimulator was used to measure the pain threshold and the pain tolerance threshold. Their age, location of pain, degrees (mild, moderate and severe pain), and courses (acute and chronic pain) were recorded. Results ① A total of 689 patients suffered from anxiety state (68.1%), while 323 patients did not show anxiety state (31.9%). The age, number of cases of chronic pain, and NRS score of the anxiety group were remarkably higher than those of the non‑anxiety group (P<0.05). There were no statistical differences in pain threshold and pain tolerance threshold between the two groups (P>0.05). For patients with pain at various degrees, patients with moderate and severe pain showed significantly higher SAS scores than those with mild pain (P<0.05). Multivariate Logistic regression analysis showed that age, pain site, and moderate pain were the independent risk factors for anxiety (P<0.05). ② A total of 306 patients suffered from depression state (30.2%), while 706 patients did not show depression state (69.8%). The depression group presented significant higher NRS score and a lower number of cases of chronic pain than the non‑depression group (P<0.05). There were no statistical differences in age, pain threshold and pain tolerance threshold between the two groups (P>0.05). The SDS scores of patients with moderate and severe pain were significantly higher than those with mild pain (P<0.05). Multivariate logistic regression analysis showed that the location of pain, moderate and severe pain were the independent risk factors for depression (P<0.05). ③ A total of 552 patients with chronic pain were divided into four groups according to their anxiety and depression (193, 102, 36 and 221 patients in the anxiety and depression group, the anxiety non‑depression group, the depression non‑anxiety group, and the non‑anxiety non‑depression group, respectively). The NRS scores of patients in the anxiety and depression group were higher than those in the anxiety non‑depression group, the depression non‑anxiety group and the non‑anxiety non‑depression group, while the NRS scores of patients in the anxiety non‑depression group and depression non‑anxiety group were higher than those in the non‑anxiety non‑depression group (P<0.05). There was no statistical difference in pain threshold and tolerance threshold among these groups (P>0.05). ④ The distribution frequency of AA, AG, and GG genotypes of the OPRM1 gene was 30.6% (409 cases), 55.5% (495 cases), and 13.9% (108 cases). The distribution frequency of A and G alleles was 58.3%, and 41.7%, respectively. Pain patients with OPRM1 mutant (AA+AG) gene were more likely to suffer from anxiety and depression than those with OPRM1 wild type (GG) gene, while pain patients with OPRM1 mutant (AA+AG) gene were more likely to suffer from anxiety and depression than those with OPRM1 wild type (GG) gene. Conclusions The incidence of anxiety and depression in female pain patients with the OPRM1 wild type (GG) gene is lower than that carrying the OPRM1 mutant (AA+AG) gene, indicating that there is a certain correlation among anxiety, depression and OPRM1 gene polymorphism in Uygur elderly female patients with pain in Xinjiang.