Objective This study aims to explore the impact of eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) on patients' mental health and quality of life, and identify the associated risk factors associated with its occurrence. Methods A retrospective analysis was conducted on 128 patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Patients were classified into eCRSwNP and noneosinophilic CRSwNP (neCRSwNP) groups based on the eosinophil (EOS) count in postoperative nasal mucosa histopathological staining. Clinical data, psychological health status, and quality of life were compared between the two groups. Univariate analysis was used to identify factors influencing the occurrence of eCRSwNP, and multivariate logistic regression was performed to determine the related risk factors for eCRSwNP. Results The eCRSwNP group exhibited significantly higher severity of symptoms such as sleep disturbances, olfactory decline, rhinorrhea, and sneezing, and had higher total scores on the Sino-nasal Outcome Test-22（SNOT-22） compared to the neCRSwNP group. Additionally, the eCRSwNP group scored higher on the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS), and lower on all dimensions of the Short Form-36 Health Survey (SF-36) (P < 0.05). Univariate analysis indicated that asthma, nasal septal deviation (NSD), peripheral blood EOS count and percentage, peripheral blood basophil (Baso) count and percentage, Lund-Kennedy score, and Lund-Mackay score were factors influencing the occurrence of eCRSwNP (P < 0.05). Multivariate logistic regression analysis identified asthma, peripheral blood EOS percentage, peripheral blood Baso count, Lund-Kennedy score, and Lund-Mackay score as independent risk factors for eCRSwNP (P<0.05). Conclusion Patients with eCRSwNP exhibit more severe clinical symptoms and are more prone to emotional disorders such as anxiety and depression. Comprehensive preoperative evaluation helps to accurately predict the subtype of CRSwNP and the postoperative course of the disease.