> The selective impact of prolonged exhalation breathing on reward responsiveness has important implications for clinical contexts, such as anxiety, panic disorder, and depression, given their distinct autonomic signatures and maladaptive reward processing. By enhancing cardiac parasympathetic modulation through prolonged exhalation techniques, individuals may restore reward processing, a valuable pathway for emotional recalibration. Prolonged exhalation harbors the potential for a low-cost, low-risk, easily applicable intervention to be incorporated into therapy or rehabilitation programs, especially to support pharmacological treatments.