Objective To identify related factors of anxiety and depression in spinal cord injury (SCI) patients based on patient-environment-occupation (PEO) model, and provide evidences for clinical practice. Methods A total of 241 patients with SCI treated between April 2014 and April 2015 were collected as the study subjects. All the patients were confirmed with SCI through CT or MRI, and had physical dysfunction. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were applied in all the 241 SCI patients to measure their psychological state. Meanwhile, PEO factors such as demographic information as well as ability of activities of daily living (ADL) and relatives’ stress were assessed by self-made questionnaire, Modified Barthel Index (MBI) and Relatives’ Stress Scale (RSS). Then, multiple stepwise regression was applied to identify significant covariance with SAS/SDS as dependent variables and other 14 factors as independent variables. Results The regression equation showed that only SDS, MBI, living environment and disease course were significantly associated with SAS. Only SAS, MBI and RSS were significantly associated with SDS. Conclusions The ability of ADL and environment are significantly correlated with psychological state of SCI patients. Early intervention of ADL and decreasing environmental barriers are needed to improve patients’ psychological state.