Background: Anemia during pregnancy remains a major global health concern and associated with both physiological and psychological consequences for mothers. Psychological well-being (PWB) plays a vital role in maternal health, influencing emotional regulation, resilience, and health-seeking behaviors. This study aimed to analyze the relationship between psychological well-being and anemia among pregnant women in Tangerang District, Indonesia. Method: A case control study design was used involving 84 pregnant women in their first to third trimesters who visited the Midwife Independent Practice in Pejamuran Village. Purposive sampling was used to recruit 42 anemic and 42 non-anemic pregnant women based on hemoglobin (Hb) measurements. Psychological well-being was assessed using Ryff’s Psychological Well-Being Scale (18-item), previously validated with a reliability coefficient of 0.705. Data were collected through structured interviews and self-administered questionnaires. Chi-Square analysis and Odds Ratio (OR) calculations were performed to examine the association between anemia status and PWB. Result: A significant association was found between psychological well-being and anemia in pregnancy (p = 0.001). Low PWB was highly prevalent among anemic women (80.95%) compared with non-anemic women (28.57%). The odds of experiencing anemia were 10.62 times higher among women with low psychological well-being than those with high psychological well-being. Conclusion: Psychological well-being is strongly associated with anemia in pregnancy, indicating the need for integrated antenatal care strategies that address both nutritional and psychological factors. Strengthening mental health support, improving counseling services, and enhancing anemia prevention programs may reduce maternal health risks and improve pregnancy outcomes.