The autonomic nervous system (ANS) plays a pivotal role in regulating involuntary bodily functions, such as heart rate, blood pressure, digestion, temperature control, and so on. Homeostasis is the interplay of the two branches (Sympathetic and parasympathetic nervous system) of the ANS and any dysfunction in the balance between the two systems can create a plethora of medical abnormalities and diseases. Hence the Understanding of the ANS, its function, and dysfunction is crucial in both clinical practice and medical education. In India, autonomic function testing has seen significant growth. Clinical applications of autonomic function testing in India are wide-ranging, with a particular focus on diagnosing autonomic disorders prevalent in the country, such as diabetic autonomic neuropathy, cardiomyopathy, and many more. The availability of advanced testing methods, such as heart rate variability analysis, sympathetic skin response testing, and tilt table testing, thermoregulatory sweat test, Quantitative Sudomotor Axon Reflex Testing (QSART) has greatly enhanced diagnostic accuracy and reproducibility. Despite its significance, autonomic function testing in India faces challenges in India related to the unequal distribution of healthcare infrastructure, inaccessibility, and lack of awareness. This comprehensive overview delves into the autonomic nervous system and its functions, historical development in autonomic function testing, clinical relevance of the Autonomic functions Tests, and challenges in autonomic function testing in India.
