Objective To explore the effect of stepped psychological care on anxiety, depression and quality of life in patients with head and neck cancer. Methods Totally, 86 hospitalized head and neck cancer patients with HADSA or HADSD score ＞7 were randomly divided into an intervention group or a control group with 43 cases each. Both groups received routine care and followups after discharge.The intervention group were additionally subjected to a stepped psychological care plan, which included 2 weeks of watchful waiting, 4 weeks of guided selfhelp, 6 weeks of facetoface problem solving therapy sessions, and 4 weeks of specialized psychological intervention and/or drug therapy.Both groups were evaluated in terms of anxiety, depression and quality of life before and after intervention. Results The intervention group had lower anxiety and depression scores than the control group, with the effective rate significantly higher than the latter （P＜0.01 for both）.The intervention group also had significant improvements in pain, swallowing, sensory function, phonation, eating ,etc., than the controls （P＜0.05,P＜0.01）. Conclusion Stepped psychological care could alleviate anxiety and depression levels of patients with head and neck cancer, and enhance the quality of life of them to some extent.