Cannabis has become a topic of much debate as a self-management option for anxiety. This has led to a closer look at what randomized trials actually show; across 19 small RCTs, anxiety outcomes—converted to a common 0–100 scale—did not differ significantly between medical cannabis and placebo at short or intermediate follow-up. The exception was a clear, acute anxiolytic signal from single-dose CBD (300–600 mg), which reduced anxiety by about 12 points within four hours, a change that met the minimally important difference. THCV, however, increased anxiety in the one trial reporting on it. THC, nabilone, and dronabinol showed no meaningful benefit. Mild adverse events such as dizziness and dry mouth were more common with cannabinoids. More rigorous trials are needed to clarify optimal dosing, duration, and which cannabinoids might actually help.