The rapid rise of esports has prompted growing concern for the mental health of esports athletes. Gaining a better understanding of the mental health status of esports athletes is crucial to recognize the health risks associated with the industry, as well as inform targeted mental health interventions. Thus, the aim of the current study was to examine the mental health status of a large sample of esports athletes, spanning different performance levels and esports titles. Using a cross-sectional survey, we examined the well-being and symptoms of common mental disorders, in an international sample of 1,105 esports athletes. Overall, 36.7% of participants reported low well-being, 44.7% experienced symptoms of depression, 33.4% experienced anxiety, and 69.3% experienced sleep disturbance. The findings suggest that the mental health burden of esports athletes may be greater than previously reported. Moreover, esports athletes of higher competitive levels and females reported higher symptoms of mental ill-health but also higher well-being, relative to esports athletes of lower competitive levels and males, respectively. Future research is needed to better understand and explain this mental health burden within esports. Additionally, this study highlights the urgent need for the design, implementation, and evaluation of context-specific targeted mental health interventions in esports.