Background Although emotional difficulties are amongst the core deficits of individuals with anorexia nervosa (AN), little is known about the specific emotional functioning. Therefore, this study uses an integrative approach to examine the emotional skills of adolescents and young adults suffering from AN compared to HC. Methods We compared the emotional skills of 32 females, aged between 14 – 35, with acute AN with 45 female healthy controls (HC). In particular, we examined alexithymia (i.e., awareness and identification of their own emotions) using the TAS-20, the capacity for identifying basic emotions expressed dynamically using a computerized morphing task, the capacity for identifying complex emotions using the Reading the Mind in the Eyes task, and nine different strategies of cognitive emotion regulation (ER) using the CERQ. Results Participants with AN displayed higher levels of alexithymia. Both groups were able to recognize basic and complex emotions in others; however, participants with AN displayed higher sensitivity in identifying anger, disgust, sadness, and surprise in others. Moreover, participants with AN reported use of specific ER strategies in comparison to HC (i.e., “acceptance” and “rumination” more so than the ER strategies of “positive refocusing”, “catastrophizing”, and “blaming others”). Conclusion Our findings document a distinct pattern of emotional functioning of individuals with AN compared to HC (i.e., difficulties in ability to recognize their own emotions; hypersensitivity to certain emotions in others and use of certain cognitive ER strategies) even if no general deficits could be identified. These results highlight the importance of considering the specific dimensions of the emotional (dys)functioning of AN in multimodal treatment approaches.