Background: Heart Rate Variability (HRV) is a very sensitive and specific noninvasive method to evaluate cardiac autonomic activity of humans. In the present study the focus is on using Heart Rate Variability to determine and compare cardiac autonomic status in asymptomatic and symptomatic menopausal women. Methods: Based on 21 postmenopausal symptoms given in The Greene Climacteric Scale, the subjects were categorized as asymptomatic menopausal women (n=50) and symptomatic menopausal women (n=50). After 10 minutes of adequate mental and physical rest, ECG was recorded in a quiet room with the subject in supine position. By using National Instruments NIDAQ 7.5 USBD 6008, Analog ECG signal was converted to digital signals. HRV software (version 1.1) was used to calculate the HRV parameters like SDNN, E: I, LF nu, HF nu, LF/HF. Results: There was a significant (p<0.001) increase in LF nu, LF/HF and a significant (p<0.001) decrease in SDNN, E/I ratio, HF nu in symptomatic menopausal women when compared with asymptomatic women. Conclusion: In symptomatic menopausal women our study showed significant increase in sympathetic activity and a significant reduction in parasympathetic activity. There was a shift in the sympathovagal balance towards sympathetic predominance among symptomatic menopausal women in contrast to asymptomatic menopausal women.