High-risk pregnant women experience stress and anxiety. Anxiety may affect prenatal attachment. This study aimed to examine the effect of anxiety on prenatal attachment in high-risk pregnant women. The study was cross-sectional and conducted on 290 high-risk pregnant women who applied to the perinatology outpatient clinic of a university hospital between February and July 2022. The data were collected with the descriptive information sheet, Prenatal Attachment Inventory (PAI), and Perinatal Anxiety Screening Scale (PASS). Mann-Whitney U, Kruskal Wallis-H, and Spearman’s Correlation tests were used to analyze the data. The mean age of the examined pregnant women was 28.12 ± 5.36, and most of them were multigravida (65.5 percent) and in the third trimester (80.7 percent). The PAI and PASS mean scores were 64.09 ± 11.31 and 27.98 ± 16.52, respectively. There was a weak positive correlation between anxiety and prenatal attachment ( = .227, < .001). The levels of prenatal attachment were higher in primigravidas and women with no children. Also, the anxiety levels of pregnant women in the third trimester were lower. Health professionals should evaluate the prenatal attachment and anxiety levels of high-risk pregnant women, and consider obstetrical factors that may influence both prenatal attachment and anxiety levels.