Anxiety symptoms are one of the most common diseases in youth worldwide. However, there is still scant literature on the role that cross-cultural factors may play in the expression and development of anxiety. Our study is aimed to compare anxiety symptoms in community based Chinese and Italian adolescents using the Spence Children’s Anxiety Scale (SCAS). In addition to the SCAS, the 3416 adolescents (13-18 years old) involved in the study, filled in the strengths and difficulties questionnaire (SDQ). A multi-group factor analysis confirmed the adequacy of a 6-factor inter-correlated model across the countries. Results supported the convergent validity between the SCAS and the internalizing behaviours and the divergent validity between the SCAS and the externalizing problems, as measured by the SDQ. Chinese adolescents reported higher anxiety symptoms than Italian ones and girls scored higher than boys. No age differences were found. In addition, a comparison between the current research and previous studies conducted in China and Italy was carried out, showing few significant differences among the studies concerning the Italian samples. However, our Chinese adolescents reported greater anxiety symptoms compared to previous studies. Results support the use of the SCAS as a potentially valuable tool for assessing anxiety symptoms in both countries. The discussion highlighted the importance to consider cultural, as well as sub-cultural issues as to promote the understanding and prevention of anxiety symptoms in adolescence.