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Previous studies have uncovered a negative correlation between problematic smartphone use (PSU) and both depression and anxiety, yet the investigation of PSU with depression and anxiety on a symptomatic level among medical students remains limited. This study aims to analyze the network structure of PSU and its relation to symptoms of depression and anxiety, as well as examine the role of mindfulness among these factors. A sample of 456 medical students was assessed using the Smartphone Addiction Scale - Short Version (SAS-SV), the nine-item Patient Health Questionnaire (PHQ-9), the seven-item Generalized Anxiety Disorder Scale (GAD-7), and the Mindful Attention Awareness Scale (MAAS). Network analysis was employed to build the network structure and to identify central and bridge symptoms with centrality indices. The analysis revealed that preoccupation with smartphone and withdrawal symptoms serve as central symptoms in the development of PSU among medical students. Excessive use and fatigue emerged as bridge symptoms linking PSU to depression, while excessive use and restlessness were identified as bridge symptoms connecting PSU with anxiety. Mindfulness exhibited a negative association with numerous symptoms across PSU, depression, and anxiety. The findings indicate that targeting preoccupation with smartphone and withdrawal symptoms might prevent the development of PSU among medical students. Targeting excessive use may be essential in preventing the progression of PSU to depression and anxiety. Given the backgrounds of medical students, online mindfulness interventions could be a viable approach to mitigate PSU and improve mental health among them.