Background <p>Being overweight contributes to increased health risks, particularly cardiac and metabolic disorders, in young adult women. This study compares the effects of Retro Walking (RW) and Forward Walking (FW) on cardiac autonomic function, cardiorespiratory fitness, and body composition in overweight female university students.</p> Methods <p>A randomized-controlled trial divided 30 overweight female students into RW, FW, and control groups. Cardiac autonomic function was assessed using Heart Rate Variability (HRV), cardiorespiratory fitness via VO2max and Heart Rate Recovery (HRR), and body composition through Body Mass Index (BMI), waist circumference (WC), and hip circumference (HC).</p> Results <p>RW demonstrated significant improvements in cardiac autonomic function, indicated by increases in SDNN (<i>p</i> &lt; 0.001), RMSSD (<i>p</i> &lt; 0.001), and pNN50 (<i>p</i> &lt; 0.001), as well as higher HF power (<i>p</i> &lt; 0.001), suggesting enhanced vagal tone and potential reductions in sympathetic activity. Both RW and FW improved cardiorespiratory fitness, with RW having a more pronounced effect on VO_2max (<i>p</i> &lt; 0.001) and immediate HRR (<i>p</i> &lt; 0.001), although no significant difference was found between groups in post hoc analysis. RW led to greater reductions in BMI (<i>p</i> = 0.002), WC (<i>p</i> &lt; 0.001), and HC (<i>p</i> &lt; 0.001) compared to FW and control groups.</p> Conclusion <p>RW emerges as a beneficial exercise modality for managing obesity-related health risks in overweight young adult women, providing superior improvements in cardiac autonomic function, cardiorespiratory fitness, and body composition over traditional FW.</p>