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Background Heart rate variability (HRV) decreases in Parkinson’s disease (PD) and it can be considered a marker for cardiovascular dysautonomia.Purpose To evaluate long-term time-domain analysis of HRV of PD patients and compare the results with those of matched healthy individuals.Method Idiopathic PD patients without comorbidity impairing HRV, and age-matched healthy individuals were recruited in a pilot study. A long-term time domain analysis of HRV using 24-hour ambulatory ECG was performed.Results 18 PD patients fulfilling inclusion criteria completed the evaluation (mean age was 55.6 ±8.8, disease duration: 5.0±4.7). Mean SCOPA-AUT score was 10.1±7.3. Patients were on Hoehn & Yahr stage 1-2 and mean Levodopa Equivalent Dose (LED) was 311 ± 239.9. Mean of the 5-minute standard deviation (SD) of R-R intervals distribution (SDNN) for all 5 min segments of the entire recording (ISDNN) was significantly lower in patients compared to controls. ISDNN significantly correlated with age, LED, levodopa and SCOPA-AUT scores.Conclusion In our population characterized by mild to moderate disease severity, time-domain assessment of HRV seemed to be a potential tool to characterize cardiovascular dysautonomia. Decrease of ISDNN in PD may reflect a circadian overall sympathetic and parasympathetic disarrangement.