Anxiety is becoming increasingly common, presenting a significant mental health challenge. Current diagnostic methods using scales have limitations. Music therapy has been shown to help regulate emotions and reduce anxiety symptoms. A recent study utilized functional near-infrared spectroscopy (fNIRS) to investigate how music therapy affects anxiety by measuring levels of oxygenated and deoxygenated hemoglobin in the brain. This study is the first to apply fNIRS in this context. It involved 83 participants, including 17 in a healthy control group and 66 in an anxiety group, which was further divided into a music therapy intervention group and a waiting-list group. After 12 sessions of music therapy, the intervention group showed significant changes in brain connectivity, particularly between Wernicke’s area and the dorsolateral prefrontal cortex, and the visual association cortex and Broca’s triangular area. These findings indicate that specific brain connectivity patterns are linked to anxiety, and music therapy can enhance these connections. Additionally, fNIRS could provide biomarkers for early identification and intervention of anxiety symptoms. The study is registered with ClinicalTrials.gov under identifier NCT05648539.