Background and Purpose The increasing evidence for neurally mediated cardiac damage and sudden death has focused attention on the central autonomic control of cardiac function. Power spectral analysis of heart rate variability(HRV) can detect autonomic consequences of stroke. We performed power spectral analysis of heart rate variability from 24-hour holter recording to identify cerebral hemispheric lateralization and gender effect in cardiac autonomic control. Methods Data were obtained from 24-hour holter recordings in 30 consecutive patients with hemispheric brain infarction in the subacute phase. We analysed the time domain and frequency domain measures of HRV and ST segment by hemispheric lateralization and Gender. Results ST segment was depressed in women compared with man. There was no statistically significant differences between right and left hemisphere stroke patients in any standard index of HRV and ST segment changes. Conclusions These data are partial consistent with evidence from the recent literature that two cerebral hemispheres and gender have a differential influence on the nature and severity of cardiac dysfunction. We think the prospective and definite study was necessary.