Background: The anxiety and stress level of both parent and child seeking treatment at the emergency department is assumed to be high. However, it is rarely quantified as to ascertain any need for intervention. Objective: The study seeks to quantify anxiety of parents accompanying sick children presenting acutely to the emergency department and to explore possible pre-visit factors that may contribute to anxiety. Methods: A 12-month cross-sectional study was conducted at the Emergency Department, Universiti Kebangsaan Malaysia Medical Centre. All parents accompanying a child presenting to the study location, fitting the inclusion and exclusion criteria, were invited to participate. Parents required to fill a self-administered questionnaire on anxiety, State-Trait Anxiety Inventory and any related factors that can influence anxiety. Results: A total of 233 subjects were recruited. The mean state anxiety score was 53.48 ± 11.36, compared to the mean score for trait anxiety of 39.85 ± 7.66, suggesting a heightened state of anxiety. Majority of subjects (65.7%) had reported clinically detected anxiety as defined by state anxiety score above 49. There was no significant association between parental anxiety level with pre-visit factors: children’s age, duration of illness, the presence of co-morbidities, time of presentation, prior medical contact and primary care referral. The child’s state of illness was the dominant psychosocial factor associated with parental anxiety reported by the subjects. Conclusion: Parental anxiety upon arrival appeared to be significantly higher than expected, suggesting intervention may be needed.