OBJECTIVES: Hypertension (HTN) is considered as chronic medical condition. Because of the increased complications associated with the conventional medicine, the effects of naturopathic modalities were emphasized to prevent and minimize those adverse effects. This study was done to assess the immediate effect of neutral spinal compress on heart rate variability and blood pressure and thereby to substantiate the clinical understanding of its effect in hypertensive individuals. METHODS: Hundred hypertensive individuals were recruited for the study. Subjects were assessed for Blood Pressure (BP) and Heart Rate Variability (HRV) before and immediately after the intervention of 20 min. RESULTS: Result shows significant reduction in mean Heart Rate (HR) (p<0.001), Low Frequency (LF) (p<0.001), Low Frequency/High Frequency (LF/HF) (p<0.001), Systolic blood pressure (SBP) (p<0.001) and Diastolic blood pressure (DBP) (p<0.001) and significant increase in mean R-R interval (Mean RR) (p<0.001) and High frequency (HF) (p<0.001) components of Heart Rate Variability after neutral spinal compress intervention. CONCLUSIONS: The results of the study reported that full neutral spinal compress reduces the sympathetic tone and shifts the Sympatho-vagal balance in favor of parasympathetic dominance and hence it can be concluded that neutral spinal compress can be effectively used in the management of hypertension. TRIAL REGISTRATION: Clinical Trial Registry- India (CTRI); CTRI Reg. No- CTRI/2020/01/022639.