Background: Dental anxiety is a common psychological issue that can influence oral health behaviors and contribute to conditions like gingivitis. Objective: This study aimed to assess the relationship between dental anxiety, gingivitis, and oral hygiene scores in a cohort of 255 patients. Methods: A cross-sectional study was conducted on 255 patients in dental hospital Karachi. Dental anxiety was measured using the Modified Dental Anxiety Scale (MDAS), gingivitis severity was assessed using the Loe and Silness Gingival Index (GI), and oral hygiene was evaluated using the Plaque Index (PI). Data were analyzed using descriptive statistics and correlation analysis. Results: The mean MDAS score was 13.8 (± 4.5), indicating moderate levels of dental anxiety. A significant positive correlation was found between dental anxiety and gingivitis severity (r = 0.32, p < 0.01), as well as between dental anxiety and poor oral hygiene (r = -0.27, p < 0.05). Additionally, a strong positive correlation was observed between poor oral hygiene and the severity of gingivitis (r = 0.45, p < 0.01). Subgroup analysis revealed that younger individuals had higher levels of dental anxiety and poorer oral hygiene compared to older participants. Conclusion: It is concluded that dental anxiety significantly influences oral hygiene practices and contributes to the severity of gingivitis. Addressing dental anxiety through targeted interventions could improve oral health outcomes. Further research is needed to explore the long-term impact of dental anxiety on oral health and develop strategies for its management.