Examined the prevalence of nicotine dependence and its relationship to depression and anxiety among Saudi university students. A sample of university students were selected, including equal number of males and females. Students were asked to fill out the World Health Organization questionnaire on smoking and the Hospital Anxiety Depression Scale (HADS). A semi-structured interview was used on a pilot sample of students to ensure the validity of the HADS in the non-clinical population. The Fagerstrom Tolerance Questionnaire was used to identify nicotine dependents. The prevalence of nicotine dependence was 3.3% of the total sample and 20.7% of the smokers. Nicotine dependents were not different from non-dependent in demographic data, but they smoked more cigarettes for a longer duration, had difficulty in refraining from smoking in prohibited places, smoked even when very ill and inhaled smoke into their lungs. Also, they had significantly more cases of depression and anxiety than non-dependent. Findings sugest that nicotine dependence is associated with depression and anxiety among Saudi university students.