This study investigates the emotional and cognitive factors of individuals’ behavioral intention to engage in Complementary and Alternative Medicine (CAM). Drawing on an affective-cognitive framework, the study focuses on four key psychological variables: perceived usefulness, self-efficacy, enjoyment, and trust. While prior CAM research has largely emphasized rational decision-making processes and health belief models, this study incorporates emotional and motivational dimensions to provide a more holistic understanding of user engagement. A cross-sectional online survey of 176 South Korean adults with prior CAM experience was conducted using non-probability sampling, which limits the generalizability of the findings. Data were analyzed through descriptive statistics, correlation analyses, and simple linear regressions, with missing data handled via listwise deletion. All regression models were statistically significant (F(1, 174) ≥ 20.90, p < .001). The analysis revealed that all four variables significantly influenced CAM engagement, with self-efficacy and trust emerging as the strongest factors. These findings highlight the significance of both cognitive beliefs and emotional experiences in shaping behavioral intention toward CAM use. The results support a dual-pathway framework that integrates affective and cognitive influences, suggesting that enhancing emotional satisfaction, relational trust, and users’ self-efficacy is as important as communicating clinical benefits. Practically, CAM providers should design services that foster emotional connections and strengthen users’ confidence in self-care to promote sustained engagement.