Anxiety disorders are among the most prevalent mental health disorders in adolescents. This cross-sectional study examined the relationship between anxiety symptoms and occupational performance in adolescents; no prior literature on this topic has been found. Adolescents ages 13 to 17 (N = 30) referred to anxiety services in a hospital setting were assessed. The five self-reported variables investigated included: (a) perception of occupational performance, (b) satisfaction with occupational performance, (c) levels of anxiety symptoms, (d) levels of depressive symptoms, and (e) stress levels. Occupational performance issues were identified using the Canadian Occupational Performance Measure. Significant positive correlations were found between perceptions of, and satisfaction with, occupational performance and anxiety symptoms in younger adolescents (ages 13.0 to 15.3), but not older adolescents (ages 15.4 to 17.9). The relationships between anxiety symptoms and occupational performance and satisfaction are complex and may be different for younger adolescents versus older adolescents and adults.