Purpose: This study examined anxiety and depression among 108 North Korean adolescent and young adult (age, 12-29 years) defectors who settled in South Korea,and evaluated the relationship between their mental health and health-related quality of life (HRQoL). Materials and Methods: Subjects completed a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), the Short Form with 36 questions (SF-36; consists of mental and physical health components)for measuring HRQoL, and items related to the period of time since defection and settlement and socio-demographic variables. Results: Among the participants,53.7% scored≥8 on the anxiety measure questionnaire, and 22.2% scored≥ 11; 36.1% of the participants scored≥8 on the depression measure questionnaire and 14.8% scored≥11. Both anxiety and depression subscales were associated with lower scores of total SF-36, physical component and mental component score. Depressive symptom appeared more frequently among the subjects who had lived in South Korea for <1 year than among the subjects who had lived in South Korea for 2 year or longer (odds ratio=3.77, 95% confidence intervals=1.12 to 12.70). Conclusion: Among North Korean adolescent and young adult defectors, anxiety and depression were associated with lower HRQoL. Therefore, it is needed to develop strategies to screen for mental health and intervene to reduce anxiety and depression during their early resettlement stage.