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Objective: To assess the effectiveness of Reiki in reducing anxiety, depression, and improving preoperative well-being in cardiac surgery., Method: A non-randomized, two-arm controlled clinical trial conducted in a cardiology referral hospital with patients in the preoperative period of cardiac surgery, with up to five days for surgery, between May and November 2018. The intervention group (n=31) was submitted to a Reiki protocol, and the control group (n=59) received only conventional care., Results: One hundred twenty-four patients were assessed. The mean anxiety and depression did not obtain a significant difference between the groups. Spiritual well-being, in religious and existential dimensions, has improved significantly., Conclusion: Anxiety and depression were lower in the intervention group, with no statistically significant difference. There was a better result in the assessment of well-being with the intervention group. Religiosity may interfere in some cases with acceptance of holistic and integrative practices. Brazilian Registry of Clinical Trials: RBR-4cxw37.