BACKGROUND: Emergence agitation in pediatric anesthesia is associated with preanesthesia child anxiety, which is strongly influenced by maternal mental conditions. Mental stress affects the autonomic nervous system, thereby influencing heart rate variability (HRV). The present study tested the correlations between preanesthesia maternal HRV and perioperative child behavior. METHODS: A total of 27 pairs of mothers and children were analyzed in the present study. Maternal HRV was recorded from the night before the child\'s surgery to arrival to the operation room and thereafter recorded data were analyzed. The children underwent minor plastic surgery under general anesthesia, and induction and emergence behavior were assessed. RESULTS: Quality of mask induction did not correlate with the ratio of low-frequency (LF) components to high-frequency (HF) components (LF/HF ratio) of preanesthesia maternal HRV either obtained during 21:00-06:00 (stage I) or 06:00-08:00 (stage II). Scores of the child\'s emergence behavior did not correlate with the LF/HF ratio of maternal HRV of stage I; however, the LF/HF ratio of maternal HRV of stage II significantly correlated with emergence behavior. CONCLUSIONS: Two-hour maternal HRV just before surgery significantly correlated with emergence behavior of children undergoing general anesthesia.