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OBJECTIVE Coronary slow flow (CSF) is an angiographic finding detected in patients presenting with chest pain and with normal coronary artery appearance on routine angiograms. Heart rate recovery index (HRRI) reflects autonomic function and independently predicts cardiovascular disease. The aim of the study was to evaluate HRRI in patients with CSF. PATIENTS AND METHODS The study was conducted with a total of 200 individuals including 72 (36%) females and 128 (64%) males who presented to the cardiology clinic. Coronary blood flow was calculated numerically using the TIMI frame count (TFC) method. Treadmill stress electrocardiogram (ECG) test was applied to all patients according to the Bruce protocol. HRRIs at 1, 2, 3 and 5 minutes were recorded after the stress test. HRRI was calculated by subtracting the HR at 1, 2, 3 and 5 minutes of recovery from the subject's maximal exercise HR at the end of the exercise. RESULTS Duration of exercise, METs, max. HR, SBP and DBP at baseline, max. SBP and DBP, and changes in SBP and DBP were similar between the groups (p>0.05). HRRIs at 1, 2, 3 and 5 minutes were higher in CSF patients compared to control subjects (all p<0.001). CONCLUSIONS Coronary slow flow affects HRRI values. CSF may adversely affect the neuro-cardiovascular system.