The aim of this study was to explore the link between fear of falling and factors that may contribute to falls in patients with primary Sjögren's syndrome (pSS). Our study included a total of 67 patients with pSS, aged between 18 and 65. The following tests were performed on each of them by the same researcher: (I) Pain Quality Assessment Scale (PQAS); (II) Berg Balance Scale (BBS); (III) Pittsburgh Sleep Quality Index (PSQI); (IV) Medical Outcomes Study 36-Item Short Form Health Survey (SF-36); (V) Tampa Kinesiophobia Fatigue Scale Questionnaire (TSK-F); (VI) International Falls Efficiency Scale (FES-I); (VII) Timed Up And Go Test (TUG). Disease activities were recorded using the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) criteria. The following factors were associated with a fear of falling: (I) Deterioration in sleep quality (p = 0.031), (II) A decline in general health perception (p < 0.001), (III) Increased severity of pain (p < 0.001), (IV) Kinesiophobia (p < 0.001), (V) Difficulties with timely getting up and walking (p < 0.001), (VI) Increased disease activity (p < 0.001). There is no information available regarding the prevalence or contributing factors of fear of falling in individuals with pSS. This is the first study to examine fear of falling and contributing factors cross-sectionally in a sample of adults with pSS. These findings could aid in the development of a screening instrument to find modifiable risk factors for individuals with pSS who are susceptible to falling anxiety.