To systematically elucidate the central role of the cardiac autonomic nervous system (ANS) in maintaining cardiovascular homeostasis, analyze the pathological mechanisms underlying its dysregulation, integrate multidisciplinary research findings from the U.S. stimulating peripheral nerves to alleviate disease symptoms (SPARC) program, and evaluate the unique advantages and current limitations of acupuncture in modulating cardiac ANS function, ultimately proposing novel strategies for the prevention and treatment of cardiovascular diseases. A systematic literature review was conducted to synthesize current knowledge on the fundamental regulatory mechanisms of the cardiac ANS, the SPARC program's innovative contributions to neuroanatomy and neural pathway mapping, as well as clinical and experimental evidence supporting acupuncture's modulation of the ANS. The SPARC program has made significant progress in elucidating the anatomical organization and neural circuitry of the cardiac ANS through interdisciplinary collaboration, offering novel insights and methodological frameworks for studying cardiac autonomic regulation. Acupuncture, as a cornerstone of traditional medicine, has demonstrated both specificity and multi-target regulatory effects on the cardiac ANS through clinical and experimental studies. However, challenges remain, including an incomplete mechanistic understanding, technical limitations in research methodologies, and difficulties in translating findings into clinical practice. Future research on acupuncture should build upon its inherent strengths while advancing its integration with modern scientific and technological approaches. Strengthening interdisciplinary collaboration and leveraging artificial intelligence can open new frontiers in mechanistic exploration and technological innovation. These efforts will facilitate the internationalization of acupuncture research and contribute innovative perspectives and therapeutic strategies for cardiovascular disease prevention and treatment.