Adolescents with congenital heart disease (CHD) are at increased risk of emotional disturbances and sleep disorders, which may impact their ability to engage in physical activity and sports participation. This study aimed to evaluate the emotional and sleep status of adolescents with CHD and explore the implications for their overall well-being and physical activity levels. Methods: A total of 69 participants underwent assessments, including 47 adolescents with CHD (55.3% female) as the experimental group and 22 healthy adolescents (50% female) as the control group. Among the CHD patients, 21 had single malformations (61.9% female) and 26 had compound malformations (50% female). Emotional and sleep parameters were evaluated using the PHQ-9, GAD-7, PSQI, IES-R, PCL-C, and ASLEC scales. Results: Adolescents with CHD demonstrated significantly higher scores on the PHQ-9 and GAD-7 compared to the control group (P < 0.05), indicating elevated levels of depression and anxiety. Within the CHD cohort, those with compound malformations exhibited significantly higher scores on both scales than the control group (P < 0.016). Symptom analysis revealed that depressive symptoms in the compound malformation group were primarily characterized by fatigue (P < 0.016), while anxiety symptoms were predominantly related to difficulty relaxing (P < 0.016). Conclusion: Adolescents with CHD, particularly those with complex congenital malformations, are at an elevated risk of depression, anxiety, and specific emotional symptoms. These findings highlight the need for regular psychosocial screening and targeted interventions to support emotional well-being and promote physical activity in this population. By addressing emotional and sleep challenges, healthcare providers can enhance adolescents' readiness for participation in sports and physical rehabilitation programs, fostering improved quality of life and holistic health outcomes.