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The main aim of this narrative review is to assess the existing body of scientific literature on heart rate variability (HRV) in relation to basketball, focusing on its use as a measure of internal load and vagal nerve responses. Monitoring HRV offers insights into the autonomic function and training-induced adaptations of basketball players. Various HRV measurement protocols, ranging from short-term to longer durations, can be conducted in different positions and conditions, such as rest, training, and sleep, to determine this key metric. Consistency and individualization in measurement protocols, responding to the athlete's specific characteristics, is crucial for reliable HRV data and their interpretation. Studies on HRV in basketball have explored psychological adaptation, training effects, individual differences, recovery, and sleep quality. Biofeedback techniques show positive effects on HRV and anxiety reduction, potentially enhancing performance and stress management. The scientific literature on HRV in basketball could benefit from studies involving longer monitoring periods to identify significant trends and results related to training and recovery. Longitudinal HRV monitoring in teams with intense travel schedules could reveal the impact on athletes of all levels and ages, and, in this regard, individualized interpretation, considering the subjective recovery and fitness levels of athletes, is recommended to optimize training programs and performance. HRV provides insights into training and competitive loads, aiding in determining exercise intensities and training status. Additionally, HRV is linked to recovery and sleep quality, offering valuable information for optimizing player performance and well-being. Overall, HRV is a reliable tool for adjusting training programs to meet the specific needs of basketball players. [ABSTRACT FROM AUTHOR]