Cardiovascular diseases are important causes of morbidity and mortality in postmenopausal women. A major determinant of cardiovascular health is the status of autonomic nervous system and assessment of Heart Rate Variability (HRV). Heart Rate Variability is a noninvasive and sensitive technique to evaluate cardiovascular autonomic control. Reduced HRV is an independent risk factor for the development of heart disease. This study evaluated the risk factors for cardiovascular diseases using HRV, between urban and rural Indian postmenopausal women ranging in age from 40 to 75 years. Findings of the analysis of HRV have showed that the total power which reflects overall modulation of cardiac autonomic activity (759 ± 100 versus 444 ± 65), the absolute power of high frequency which is surrogate of cardiovagal activity (247 ± 41 versus 163 ± 45), and low frequency that reflects cardiac sympathetic activity (205 ± 26 versus 127 ± 18) were significantly higher in urban women than that of their rural counterparts. Further, among the anthropometric measures, waist circumference was significantly correlated with indices of HRV. The study concludes that rural Indian women are associated with an additional risk beyond that of ageing and postmenopausal status when compared to the urban women. The higher central obesity could be the contributing factor for developing higher risk for cardiovascular disease among the rural women.