Whereas there is strong evidence for a high prevalence of alexithymia among patients with alcohol dependence and mixed substance abuse, no study has investigated the association between cannabis use and alexithymia. In this study, we assessed the prevalence of alexithymia, as measured by the 20-item revised Toronto Alexithymia Scale (TAS-20), in a group of newly abstinent cannabis abusers (N = 60) who abused cannabis exclusively. We found a large difference in the rate of alexithymia between cannabis abusers with and without comorbid DSM-III-R depressive disorders. Only 7% of nondepressed cannabis-abusing subjects were alexithymic. In contrast, 57% of cannabis abusers with comorbid major depression, dysthymia, or adjustment disorder with depressed mood were alexithymic. The prevalence rate of alexithymia among the cannabis abusers with comorbid depressive disorders was similar to that (50%) found in a control group of pure depressives, even though the TAS-20 F1 subscale discriminated between the two groups (depressed cannabis abusers had more difficulty identifying their feelings than pure depressives). These results suggest that a syndromal diagnosis of comorbid depression may be a major confounding variable in the assessment of alexithymia (as measured by the TAS total score) among subjects with cannabis abuse and dependence. Depression 3:246–249 (1995/1996). © 1996 Wiley-Liss, Inc.