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Objective To explore the role of cognitive emotion regulation (CER) in the association between parenting self-efficacy (PSE) and state anxiety in parents of children undergoing surgery. Method In a prospective design, parents of 114 children admitted to hospital for planned surgical interventions completed self-report questionnaires assessing PSE, CER, and state anxiety. Mediational and moderational analyses were conducted to test competing theoretical models regarding the role of CER in the relationship between PSE and parents’ anxiety. Results The mediational model was rejected, whereas the findings supported a moderational model. The use of nonadaptive CER moderated the effect of PSE on parents’ anxiety. Higher PSE only predicted lower postsurgery anxiety when low use of nonadaptive CER was present. Conclusions Interacting cognitive factors contribute to parents’ anxiety after a child’s surgery. Both PSE and CER should be targeted in parent interventions promoting successful adjustments to surgery on children.