Purpose: This study was done to examine differences in the factors affecting Hwa-byung symptoms in middle-aged men and women. Method: There search design for this study was a descriptive survey design using a convenience sampling. Data collection was done using self-report questionnaires with 381 middle age people (169 men and 212 women) in Seoul and G city. ANOVA, t-test, Pearson correlation coefficients and stepwise multiple regression were used to analyze the data with SPSS Win 18.0 Program. Results: There were significant differences in Hwa-byung symptoms and life stress between men and women. However anger rumination and mood states were not significantly different by gender. In multiple regression analysis, mood states, religion, and employment were significant predictors and explained 36% of Hwa-byung symptoms for men. In women, mood states, life stress, anger rumination and employment were significant predictors and explained 41% of Hwa-byung symptoms. Conclusion: Findings of this study provide a comprehensive understanding of Hwa-byung symptoms and related factors between men and women in Korea. However, further study with a larger random sample from various living environment is necessary.