Background : There are findings indicating that the autonomic nervous system (ANS) is affected negatively in atopic dermatitis (AD). Heart rate variability (HRV) is a tool to examine ANS. But, studies investigation the relationship between AD and HRV is rare. Objective : The aim of this study was to investigate the correlation between atopic dermatitis severity and HRV and to find out the role of ANS in AD. Methods : Retrospective chart review was performed. The Severity Scoring Atopic Dermatitis (SCORAD) index and HRV parameter was investigated and analyzed. Results : There were 55 patients (25males and 30 females) who met the criteria. Objective SCORAD had significant positive correlation with HRT and Subjective SCORAD had significant negative correlation with SDNN, TP and VLF. Intensity item of SCORAD index had negative correlation with most HRV parameters, but TP, LF and LF/HF ratio had significant positive correlation with dryness. Conclusion : This study supports the concept that atopic dermatitis is a stress-responsive disorder and involves autonomic nervous system dysfunction.