Objective To explore the effects of low-dose dexmedetomidine-assisted epidural labor analgesia on labor anxiety and postpartum depression in primiparae. Methods A total of 60 primiparae were enrolled as the research subjects and randomly divided into a control group and an observation group, with 30 cases in each group. Both groups of primiparae underwent vaginal delivery and received epidural labor analgesia. Among them, the formula of analgesia pump in the observation group contained 0.1% ropivacaine + 0.3 μg/mL sufentanil + 0.2 μg/mL dexmedetomidine, while that in the control group contained 0.1% ropivacaine + 0.5 μg/mL sufentanil. The Self-Rating Anxiety Scale (SAS) was used to assess the severity of anxiety in both groups of primiparae before epidural labor analgesia and active phase of labor. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the severity of depression in both groups before epidural labor analgesia and at 42 days postpartum. Data on blood pressure, heart rate and Visual Analogue Scale (VAS) pain score were recorded in both groups of primiparae at the following time points: before epidural labor analgesia (T0), 30 minutes after epidural labor analgesia (T1), active phase of labor (T2), during delivery (T3), and 2 hours after delivery (T4). Additionally, the occurrence of adverse reaction was documented. Results Before epidural labor analgesia, there were no statistically significant differences in SAS scores between the two groups (P>0.05), whereas during the active phase of labor, SAS scores in the observation group were lower than those in the control group (P<0.05). There were no statistically significant differences in EPDS scores between the two groups before epidural labor analgesia and at 42 days postpartum (P>0.05). At time points T1, T2, T3, and T4, VAS pain scores in the observation group were lower than those in the control group (P<0.05). Meanwhile, there were no statistically significant differences in levels of blood pressure, diastolic blood pressure and heart rate between the two groups (P>0.05). Additionally, the incidence of adverse reactions including dizziness, vomiting, pruritus and urinary retention showed no statistically significant difference between the two groups (P>0.05). Conclusion Low-dose dexmedetomidine-assisted epidural labor analgesia can effectively alleviate pain during delivery, mitigate anxiety, and does not increase the incidence of relevant adverse reactions.