OBJECTIVE: Ice massage (IM) is one of the treatment procedures used in hydrotherapy. Though its various physiological/therapeutic effects have been reported, effects of IM of the head and spine on heart rate variability (HRV) have not been studied. Thus, this study evaluated the effects of IM of the head and spine on HRV in healthy volunteers. METHODS: Thirty subjects were randomly divided into 3 sessions: (1) IM, (2) tap water massage (TWM) and (3) prone rest (PR). Heart rate (HR) and HRV were assessed before and after each intervention session. RESULTS:A signifi cant increase in the mean of the intervals between adjacent QRS complexes or the instantaneous HR (RRI), square root of mean of sum of squares of differences between adjacent normal to normal (NN) intervals (RMSSD), number of interval differences of successive NN intervals greater than 50 miliseconds (NN50), proportion derived by dividing NN50 by total number of NN intervals along with signifi cant reduction in HR after IM session; signifi cant increase in RRI along with signifi cant reduction in HR after TWM, and a signifi cant increase only in RMSSD after PR were observed. However, there was no signifi cant difference between the sessions. CONCLUSION: Results of this study suggest that 20 min of IM of the head and spine is effective in reducing HR and improving HRV through vagal dominance in healthy volunteers.