Burnout has been associated with increased risk of cardiovascular disease. This relationship may be mediated by a stress-related disruption in cardiac autonomic activity. The aim of the present study was to assess cardiac autonomic activity (sympathetic and parasympathetic) during a working day in burned out managers. Thirty burned out, 29 healthy control and 29 engaged managers (a psychologically contrasting group) were identified using the Maslach Burnout Inventory-General Survey (MBI-GS) and the Utrecht Work Engagement Scale (UWES). Twenty-four-hour ambulatory measurements were carried out during a regular workday and the subsequent night. Pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) were used as measures of cardiac sympathetic and parasympathetic activity, respectively. Contrary to expectations, the burned out, engaged and control groups did not differ in cardiac sympathetic and cardiac parasympathetic activity, or heart rate. Thus, burnout does not seem to be associated with an unfavourable cardiac autonomic profile. Copyright © 2009 John Wiley & Sons, Ltd.