Agreement between cancer patients and their physicians in assessing patient anxiety during a follow-up visit was studied in two samples: one at the Department of Gynaecological Oncology (GYN, n = 60) and one at the Department of Surgery (SURG, n = 141). All were ambulatory cancer patients attending regular follow-up visits. Physicians estimated patient anxiety immediately after the visit, while patients assessed this aspect at home later the same day or some days later. The results show that physicians were unable to adequately estimate patients, general anxiety during the visit. Physicians typically overrated the anxiety of not anxious or mildly anxious patients, and showed limited ability to estimate individual patients, anxiety in terms of rank. Physicians made gross misjudgements ( >4 points on a 0–10 scale) of patient anxiety in 20% of cases. Theoretical explanations for this lack of patient-physician agreement are discussed.