IntroductionSurgical fear is common and has a negative impact on surgery and its outcome. Recent research has identified individual religiousness as an important factor among patients with associations to mental health, particularly anxiety.ObjectiveThis study aimed to examine associations between religiousness and surgical fear in a representative sample of adult surgical patients in Croatia.DesignCross-sectional study among elective surgery patients at different departments of a single hospital.SettingUniversity Hospital Sveti Duh, a tertiary health care facility in Croatia.MeasurementsReligiousness and surgical fear were the variables of interest and assessed through self-report instruments. The Croatian version of the Duke Religiosity Index questionnaire (DUREL) assessed organizational religious activity (ORA), non-organizational religious activity (NORA), and intrinsic religiousness (IR). The Croatian version of the Surgical Fear Questionnaire (SFQ) measured surgical fear and its subscales the fear of the short-term and long-term consequences of surgery. Additionally, sociodemographic characteristics and medical history were assessed. Analyses were carried out using descriptive and linear regression analyses.Results178 subjects were included for data analysis. Univariate linear regression found two dimensions of religiousness (non-organizational religious activity, intrinsic religiousness) to be weak, but significant predictors of greater surgical fear (adj. R2= 0.02 and 0.03 respectively). In the multiple linear regression model together with age, gender, education and type of surgery, all three dimensions of religiousness were found to be significant independent predictors of greater surgical fear.LimitationsThe study was single-center and cross-sectional and did not assess patients’ specific religious identity.ConclusionsThis study demonstrated significant positive associations between dimensions of religiousness and surgical fear, potentially suggesting that surgical patients experience increased religiousness to cope with heightened anxiety. Assessment and intervention to address patient religiousness is warranted in the context of surgical fear among religious patients, and the importance of religiousness in the context of surgical fear needs to be further addressed in research.