Worry and rumination are common forms of perseverative cognition (PC) and repetitive negative thinking towards stressors. PC can generate psychophysiological stress before or after exposure to stressors and is linked to chronic stress, diseases, and adverse health outcomes. PC has been associated with vagally-mediated heart rate variability (vmHRV). In the present meta-analytic review, effect sizes for the relationship between PC and vmHRV were computed for baseline, stressor, and recovery conditions vmHRV among studies using within-subject and between-subject analyses. A total of 55 effect sizes were extracted from 24 eligible articles (17 for baseline, 15 for reactivity, 8 for recovery). Small to medium effect sizes were observed for the correlations between PC and baseline vmHRV (g = .40, SE = .10), within-subject reactivity vmHRV (g = .27, SE = .07), and between-subject recovery vmHRV (g = .44, SE = .18). The other meta-analyses did not yield statistically significant effect sizes. High heterogeneity was detected across the meta-analyses and statistical tests suggested the absence of publication biases. Overall, PC in laboratory studies was observed to differentially associate with baseline, reactivity, and recovery vmHRV. The scarcity of vmHRV recovery studies was discussed.