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ObjectiveThis study aimed to explore the relationship between total burden of cerebral small vessel disease (CSVD) and daytime and nighttime heart rate variability (HRV) parameters.MethodConsecutive patients with nondisabling ischemic cerebrovascular events were recruited from the cerebrovascular disease clinic of Changzhou Second People's Hospital between January 2022 and June 2023. A total of 144 enrolled participants were divided into a mild CSVD group (74 patients) and a moderate-to-severe CSVD group (70 patients) based on total burden of CSVD. Various HRV parameters measured during 24-h, 4-h daytime, and 4-h nighttime periods (including natural log–transformed [ln] root mean square of successive RR interval differences [RMSSD], ln absolute power of the high-frequency band [0.15–0.4 Hz] [HF], ln absolute power of the low-frequency band [0.04–0.15 Hz][LF], and LF-to-HF ratio [LF/HF]) were then assessed in the 2 groups. Spearman correlation analysis was used to assess the correlation between total burden of CSVD and HRV parameters. HRV parameters with P-value