Introduction: This exploratory study investigated the impact of altered physiological states on emotion processing in quadriplegic patients, endurance athletes and healthy controls. High cervical spinal cord injury patients differ from both other groups in their lack of peripheral feedback and their inability to show motor approach or withdrawal behavior. However, both patients and athletes at rest are distinguished from non-athletic controls by their reduced sympathetic nervous system activity which may lead to less intense emotional experiences. Methods: We measured both physiological (event-related potentials, skin conductance, heart rate) and subjective responses (valence and arousal ratings) to stimuli from the International Affective Picture System. Results: While there were no group differences in arousal, both athletes and quadriplegics tended to rate positive slides as less pleasant and negative slides as less unpleasant than ablebodied controls. Skin conductance response was reduced in athletes and absent in quadriplegics, and both groups had greater heart rate deceleration than controls. The three groups showed similar electrocortical responses to both pleasant and unpleasant pictures. Discussion: The similarities between patients and athletes suggest that feedback of peripheral sympathicoadrenergic processes contributes to emotion processing. Further research is warranted to elucidate the contributions of autonomic nervous system activity to emotional experience.