The meaning of ANGUISH is extreme pain, distress, or anxiety. How to use anguish in a sentence. Synonym Discussion of Anguish . Anguish is great mental suffering or physical pain. Learn the origin, pronunciation, and usage of the word anguish , and see synonyms and examples from Collins English Dictionary. Anguish definition : excruciating or acute distress, suffering, or pain.. See examples of ANGUISH used in a sentence.