Preserved ratio spirometry (PRISm) is an abnormal pattern of spirometry test results associated with an increased risk of medical complications and increased mortality. A study from Saudi Arabia of 101 patients with PRIS found that 37.6% of them showed symptoms of anxiety and 26.7% of them showed symptoms of depression. In addition, 44.5% of patients had an impaired health status, 36.6% had increased shortness of breath, and 66.3% had an impaired quality of life. Patients with uncontrolled respiratory symptoms had reduced health status and higher levels of psychological symptoms compared to patients with controlled symptoms. Quality of life, health status, and respiratory symptoms were significantly worse in patients with depressive or anxiety symptoms. Depression was also associated with more comorbidities. The study highlights the need for routine screening and a comprehensive treatment approach to improve the quality of life of patients with PRISm, as it is an underdiagnosed condition without clear treatment guidelines.