Objective: To determine the prevalence and severity of psychological distress among oncology patients in Uzbekistanand to identify the principal clinical and sociodemographic factors that modulate distress intensity.Methods: A cross-sectional study was conducted at a tertiary oncology centre involving 120 adult patients withconfirmed malignant diagnoses. Psychological distress was assessed using the Hospital Anxiety and Depression Scale(HADS) and the Distress Thermometer (DT). Social support was measured via the Multidimensional Scale ofPerceived Social Support (MSPSS). Statistical analyses included Mann-Whitney U, Kruskal-Wallis, and Spearmancorrelation tests (SPSS 26.0).Results: Clinically significant distress (DT ³ 4) was identified in 64.2% of patients (mean DT 5.2 ± 2.3).HADS-defined anxiety was present in 60.8% and depression in 53.4% of participants. Advanced disease stage (StageIV vs. I–II: DT 6.8 ± 1.9 vs. 3.9 ± 2.0; p < 0.001), combined chemoradiotherapy, and low perceived social support(MSPSS < 48; r = -0.61; p < 0.001) were the strongest independent determinants of elevated distress