Background: Hypertension is one of major causes responsible for cardiovascular disease. Prehypertension, as defined by joint national commission-2003 as condition with SBP 120-139 or DBP as 80-89mmH, was identified as a precursor for hypertension and also associated with 1.5 to 2 fold increase in cardiovascular disease. The aim of the study was to determine the sympathetic reactivity in pre-hypertensives with normal and higher body mass index (BMI).Methods: A cross-sectional study was conducted at Seth G.S Medical College, Mumbai, India. A total of 129 study participants were recruited based on the inclusion and exclusion criterion of the study. Changes in diastolic blood pressure were measured in isometric hand grip and cold pressor tests.Results: The prevalence of prehypertension was observed to be 66.66% in age group of 28-40 years. There was a statistically significant difference in change of diastolic blood pressure in isometric hand grip (IHG) and cold pressor test (CPT), in prehypertensives with higher BMI as compared to prehypertensives with normal BMI.Conclusions: The finding of the study reveals that there is an increased sympathetic reactivity in prehypertensives with normal BMI as compared to normotensives. There is lesser sympathetic reactivity in prehypertensives with higher BMI compared to prehypertensives with prehypertensives with normal BMI.