The aim of the present study was to examine the moderating role of parasympathetic and sympathetic nervous system functioning on the relationship between child temperament and emotion regulation. Sixty-two 4.5-year olds (31 females) were rated by their parents on temperamental surgency. Respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) were measured at baseline and in reaction to an interaction with an unfamiliar person and a cognitive test. The preschoolers’ ability to self-regulate emotion was assessed in response to a disappointment. Results revealed little or no PEP reactivity to the unfamiliar person to be related to poorer emotion regulation for children high in surgency, indicating that the lack of sympathetic activation may be a risk factor for behavioral maladjustment. Reciprocal sympathetic activation, or increases in sympathetic activity accompanied by decreases in parasympathetic activity, was associated with better regulation of emotion for all levels of temperamental surgency supporting previous work that reciprocal activation is an adaptive form of autonomic control.