The purpose of this study was to examine the relationship between Korean pharmacy students' empathy and psychological need satisfaction and their levels of burnout and psychological well-being, using structural equation modeling. The participants were 452 pharmacy students from five South Korean universities. The Jefferson Scale of Empathy (Health Professions Students version), the Activity-Feeling States Scale, and the Maslach Burnout Inventory-Student Survey were used to assess empathy, psychological need satisfaction, and burnout, respectively. Psychological well-being was measured with the Mood Rating Scale, Self-Esteem Scale, and Satisfaction With Life Scale. The fits of the measurement and structural regression (SR) models with data on the four variables were evaluated using the Tucker-Lewis index (TLI), incremental fit index (IFI), comparative fit index (CFI), and root mean-square error of approximation (RMSEA) using AMOS 18.0. A total of 447 students (98.9%) completed the survey. The measurement model showed adequate fit indices; all hypothesized factor loadings were significant. The proposed SR model also showed an acceptable fit (TLI = 0.92, IFI = 0.94, CFI = 0.94, RMSEA = 0.072); each path was supported except the path from empathy to burnout (β = 0.005). Empathy was positively associated with psychological well-being (β = 0.18). Perceived satisfaction of psychological needs was positively related to psychological well-being (β = 0.59), but strongly and negatively related to burnout (β = - 0.71). The model explained 50 and 44% of variances in burnout and psychological well-being, respectively. Pharmacy students' empathy and psychological needs should be considered in pharmacy education systems to promote psychological adjustment.