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Background: Preoperative emotional distress has been linked to adverse health outcomes, diminished quality of life, increased symptom burden after surgery, and poorer postoperative outcomes. Therefore, this study aimed to assess the impact of perioperative emotional distress on the long-term outcomes of patients undergoing colorectal surgery. Methods: We conducted a follow-up study of a previously conducted observational study of colorectal surgery patients who underwent surgery at the University Medical Centre Freiburg, Germany, between April 2018 and February 2020. Initially, all the patients completed a multidimensional mood questionnaire (MDMQ) preoperatively and on postoperative days 3, 6, and 9. From June to November 2021, these patients were contacted again to capture the results of MDMQ at least one year after surgery and to assess the rate of late complications, quality of life, dietary changes, and overall health. Results: Of the original 80 patients, 51 took part in the follow-up study (55% female, on average 59 years old), on average 30 months after the operation. The average mood results of the surgical patients returned to those of the normal population. Most patients (80%) did not feel that their quality of life was affected by the surgery. Satisfaction with the surgical outcome averaged 8.5 out of 10, while current health was rated at 6.8 out of 10. Emotional distress levels varied over time, with mood and arousal improving significantly postoperatively. Late complications were reported by 28% of the patients, but there were no significant differences in the MDMQ scores, health status, or satisfaction between those with and without complications. Conclusions: The results indicate that there is no association between the emotional strain measured by the MDMQ and the occurrence of late postoperative complications. [ABSTRACT FROM AUTHOR]