In summary, we have shown that items used to measure the personality trait neuroticism are genetically heterogeneous, with genetic overlap often being only moderate (i.e., rg < .60), and we replicated this in a second sample. We then proceeded to conduct GWAS meta-analyses on all 12 neuroticism items and their sum-score in ≥366,276 individuals. We identified 138 item-specific loci implicating 1,247 genes, revealing considerable genetic variation between items. We identified two genetically distinct item clusters denoted depressed affect and worry. Within clusters, items were genetically strongly correlated, and items from different clusters showed distinct genetic correlational patterns to external traits.