Objectives: This study was performed to investigate the effect of hot spring therapy on children weight, body composition and heart rate variability. Methods: The study was carried out from 30 children who visited the spa from August 1, 2011 to August 31, 2011. We measured the change of weight, body composition, and heart rate variability after hot spring therapy for an hour per day. Results: The subject was consisted of 13 boys and 17 girls. This study revealed that their weight got lost from a hot spring therapy, which was statistically significant. Their body mass index(BMI) was decreased in from a hot spring therapy, which was not statistically significant. Total body water, muscle, protein, and mineral were decreased from a hot spring therapy, which was statistically significant. We measured HRV(heart rate variability) before and after the hot spring therapy. The mean HRT was increased, which was statistically insignificant. SDNN(standard deviation of the NN interval) and RMSSD(square root of the mean of the sum of the square of differences) were not different before and after the hot spring therapy. ln TP was decreased insignificantly. ln VLF was not affected before and after hot spring therapy. ln LF and ln HF was decreased, LF norm was increased, and HF norm was decreased, which were not statistically significant. Also, LF/HF ratio was increased insignificantly. Conclusions: From these results, we concluded that the weight, total body water, muscle, protein, and mineral got lost from the hot spring therapy. However, the HRV was not affected from the hot spring therapy.