Purpose This study aimed to investigate the effect of stair gait training on heart rate variability, respiratory and balance in Stroke Patients. Methods This study was a pilot study consisting of 10 patients diagnosed with stroke who met the inclusion criteria. They were randomly assigned into two groups: 5 in the study group and 5 in the control group. The study group performed stair walking training, while the control group engaged in traditional physical therapy training. Both groups participated in these exercises three times a week for 30 minutes each session, over a total of eight weeks. Dependent variable measures based on the intervention included spirometry (Pony FX) for respiratory function, heart rate variability monitor (Polar H10) for autonomic nervous system evaluation, and the Berg Balance Scale (BBS) for balance. Results There were no significant differences between the study group and the control group in HRV and BBS, but there was a significant difference in respiratory function between the two groups. Conclusion Stair walking training may have beneficial effects on heart rate variability, respiratory function, and balance in patients with right hemisphere stroke.