Background: Students with social anxiety disorder (SAD) face unique challenges that can significantly impact their academic performance, social interactions, and overall well-being. Objectives: This study aimed to explore the impact of metacognitive therapy (MCT) on depression, emotion regulation, and self-concept among students diagnosed with SAD. Methods: The study employed a quasi-experimental research design with a pre-test-post-test format and a control group. The statistical population consisted of students diagnosed with SAD at the University of Tehran in 2022. A total of 36 students with SAD were selected for the research sample through purposive sampling and were divided into experimental (n = 18) and control (n = 18) groups. The experimental group participated in ten 90-minute sessions of MCT, while the control group did not receive any intervention. Data collection involved administering the Liebowitz Social Anxiety Scale, Beck Depression Inventory, Emotion Regulation Questionnaire, and Beck Self-concept Test. The collected data were analyzed using multivariate analysis of covariance (MANCOVA) in SPSS-24. Results: The results indicated that Metacognitive Therapy (MCT) significantly decreased depression (F = 50.65, P = 0.001, η² = 0.63) and significantly increased cognitive reappraisal (F = 61.81, P = 0.001, η² = 0.67), expressive suppression (F = 34.72, P = 0.001, η² = 0.54), and self-concept (F = 48.53, P = 0.001, η² = 0.62) in students with SAD. Conclusions: The findings of this study enhance our understanding of the therapeutic benefits of MCT for students struggling with SAD. By addressing critical psychological areas such as depression, emotion regulation, and self-concept, MCT shows promise as a valuable intervention for improving the well-being and functioning of students dealing with SAD.