Global research has highlighted the pandemic’s deleterious effect on the mental health of young people, yet few longitudinal studies focus on anxiety levels in low-resource settings. The Young Lives longitudinal study (2002–2021) captured anxiety levels amongst young people aged 26 in Southern India during different phases of the pandemic. The article examines the prevalence of anxiety (measured by GAD-7) and associated factors (individual and household factors) using a multivariate logistic regression. The results reveal that nearly 15% of 26-year-olds had above minimal level of anxiety at the end of 2020, which decreased to 13% in 2021. Logistic regression analysis reveals that young women and rural youth were significantly more likely to experience anxiety. Factors such as loss of livelihood, food inadequacy and death of earning household members during the pandemic were strongly associated with above minimal level of anxiety. The findings highlight that there is an urgent need for targeted interventions to support young women and rural youth. Increased investment in mental health care, strengthening social and food security systems and integrating mental health into primary care and community-based settings are essential to better protect vulnerable populations in future crises. Read the article (behind paywall or accessible via subscription).