The current study uniquely examines mattering and narcissism and reflects our contention that pathological narcissism involves an excessive need to matter and a hypersensitivity to being devalued and not mattering to other people. Specifically, we evaluated the proposed association between pathological narcissism and deficits in mattering by comparing the results obtained with the Anti-Mattering Scale and the General Mattering Scale. We also evaluated anti-mattering as a potential mediator of the link between narcissism and distress. A sample of 168 university students completed the Anti-Mattering Scale, the General Mattering Scale, the Pathological Narcissism Inventory, and a depression measure. Results confirmed that elevated scores on the Anti-Mattering Scale are associated with grandiose and vulnerable narcissism as well as depression. Mattering assessed by the General Mattering Scale had a weaker association with narcissism, thus highlighting the distinction between the Anti-Mattering Scale and the General Mattering Scale. Further analyses suggested that elevated Anti-Mattering Scale scores did indeed mediate the link between vulnerable narcissism and depression in keeping with anti-mattering as a factor that elicits the vulnerability of narcissists. Our findings attest to the uniqueness of the Anti-Mattering Scale and illustrate the need to consider the role of feelings of not mattering as a contributor to the self and identity issues and interpersonal sensitivity that contribute to pathological narcissism. This work also suggests the need to emphasize an excessive need to matter when assessing the self and when developing future measures of the need to matter.