Introduction: Acne vulgaris is chronic inflammatory disorder of pilo-sebacious unit. Acne can cause psychiatric morbidities like depression, anxiety disorders mainly social anxiety and generalised anxiety disorder, obsessive compulsive disorder, somatisation disorder, delusional disorder, body dysmorphic disorder and suicidal ideations. Predominant adolescent prevalence of acne, distribution of lesions mostly on face, strong emphasis on external appearance have psychological impact like decreased self esteem. With this background, this study was conducted to assess psychiatric morbidity and self esteem in acne patients and to find out impact of clinical variables of acne on psychiatric morbidity. Materials and Methods: 100 patients of acne studied. Acne severity graded by dermatologist using Global Acne Grading System. Subjective grading of acne severity done by patients on visual analogue scale. Psychiatric morbidity and self esteem were assessed using DSM IV TR criteria and Rosenberg Self Esteem Scale respectively. Data thus collected subjected to statistical analysis. Results: Psychiatric morbidity was observed in 81% and low self esteem in 66% of the acne patients. Anxiety disorders (51%) were observed more than major depressive disorder (30%). Female patients, young age, subjectively perceived severe acne, facial acne were associated with higher psychiatric morbidity. Conclusions: Acne vulgaris negatively affects patients’ self esteem and cause significant higher psychiatric morbidity. Hence, treatment needs to address both the primary skin condition of acne and psychiatric manifestations.