This study examines the effects of cognitive reappraisal on the cardiovascular response to affective stimuli. Participants (N = 53) were shown affective images and were asked either to attend to the images, or to downregulate negative affect through reappraisal of negative images or upregulate positive affect through reappraisal of positive images while continuous measures of cardiovascular activity were recorded. Reappraisal of negative images was associated with lower total peripheral resistance and larger cardiac output in the prestimulus period, whereas reappraisal of positive images was associated with less pronounced decreases of heart rate, cardiac output, and mean blood pressure in the viewing period as compared to unregulated conditions. The results indicate that cognitive reappraisal engenders adaptive hemodynamic profiles both during anticipation and during viewing of affective images depending on their valence and the regulatory goal.