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Description: Objective: The ability to accurately identify facial expressions of emotions is crucial in human interaction. While a previous study suggested deficient emotional face recognition in patients with fibromyalgia syndrome (FMS), not much is known about the origin of this impairment. Against this background, this study investigated the role of executive functions. Executive functions refer to cognitive control mechanisms enabling implementation and coordination of basic mental operations. Deficits in this domain are prevalent in FMS. Methods: Fifty-two FMS patients and thirty-two healthy individuals completed the Ekman-60 Faces Test, which requires classification of facial displays of happiness, sadness, anger, fear, surprise and disgust. They also completed eight tasks assessing the executive function components of shifting, updating and inhibition. Effects of comorbid depression and anxiety disorders, and medication use, were tested in stratified analyses of patient subgroups. Results: Patients made more errors than controls in classifying expressions of all emotional categories. Moreover, their recognition accuracy correlated positively with performance on most of the executive function tasks. Emotion recognition did not vary as a function of comorbid psychiatric disorders or medication use. Conclusions: The study supports impaired facial emotion recognition in FMS, which may contribute to the interaction problems and poor social functioning characterizing this condition. Facial emotion recognition is regarded as a complex process, which may be particularly reliant on efficient coordination of various basic operations by executive functions. As such, the correlations between cognitive task performance and recognition accuracy suggest that deficits in higher cognitive functions underlie impaired emotional communication in FMS. Authors: Cristina Muñoz Ladrón de Guevara, Gustavo A. Reyes del Paso, María José Fernández-Serrano & Stefan Duschek (submitted for publication)