A comprehensive approach to the management of anxiety disorders continues to be a clinical challenge as current therapies have shown only limited efficacy. Quetiapine (available as an immediate-release and an extended-release [XR] formulation) is an atypical antipsychotic agent with primary dopaminergic and serotonergic blocking activity, which has well-established records of clinical efficacy and tolerability in the treatment of schizophrenia and bipolar disorder. Recent controlled trials provide increasing evidence in support of the role of quetiapine XR as both monotherapy and as an augmentation therapy in the treatment of several anxiety disorders, including generalized anxiety disorder, social anxiety disorder, obsessive compulsive disorder, and posttraumatic stress disorder. To date, there is only limited evidence for its use in panic disorder. Quetiapine XR is an important alternative especially for patients who had a partial remission of symptoms or who have not responded to first-line treatments for mood and anxiety disorders. It may also provide an important option in patients whose anxiety disorder is comorbid with an underlying bipolar mood disorder. Quetiapine’s safety and tolerability profile in the management of anxiety disorders is comparable to what is observed when quetiapine is used for other psychiatric conditions, however, it has yet to receive FDA approval for use in generalized anxiety disorder due to potential long-term metabolic adverse effects. Thus, given its efficacy and tolerability, it is important to consider the potential benefit of its ability to manage mood and anxiety disorder symptomatology, while closely monitoring for the more worrisome adverse events.