Introduction: Deposition of fat over the upper trunk and neck is called neck obesity. It is a topographical central fat distribution. In this cross-sectional study, it is demonstrated that individuals with neck obesity are having a hyperresponsive cardiovascular system, to the incentive spirometry breathing exercise as compared to abdominal obese individuals. Objective: To check sustained maximal inspirations using incentive spirometry (IS) as a tool for cardiovascular (CVS) responses of the neck and abdominal obese individuals. Methods: Sample size and population: N=30 individuals (15 with neck obesity and 15 with abdominal obesity volunteered and gave written informed consent to participate. The setting was the Research Lab of AIPT, Amity University, Noida, UP. India. Inclusion Criteria: Age group: 18-30 years; BMI __ampersandsignge;25kg/cm2 ; Circumference of abdomen __ampersandsignge; 88 cm in females and __ampersandsignge; 102 cm in males; [abdominal obesity group]; Circumference of neck __ampersandsignge; 35 cm in females and __ampersandsignge; 41 cm in males. [neck obesity group]. Ex clusion Criteria: Any previous history of cardiovascular disease; Uncontrolled diabetes mellitus; Hb, __ampersandsignlt;10mg/dl; Known asthma; known COPD; Smoking history.Intervention: Sustained maximal inspirations 10 per minute were carefully administered. Outcome measures: heart rate, blood pressure responses. Results: Significant changes in systolic blood pressure (SBP) __ampersandsignamp; heart rate (HR) are seen between the neck and abdominal obese population (p__ampersandsignlt;0.05) at 95% CI. Pre incentive spirometry Sustained Maximal Inspiration breaths, SBP of abdominal obese individuals (mean__ampersandsignplusmn;SD-115.47__ampersandsignplusmn;7.38) was higher than neck obese (mean__ampersandsignplusmn;SD-108.73__ampersandsignplusmn;8.54) at (p = 0.028*); whereas post-incentive spirometry SBP was more in neck obese ((mean__ampersandsignplusmn;SD-126.80__ampersandsignplusmn;7.84 ) than in abdominal obese ((mean__ampersandsignplusmn;SD-114.0__ampersandsignplusmn;11.0) at (p = 0.001*). HR also increased significantly post incentive spirometer in neck obese (mean__ampersandsignplusmn;SD-100.53__ampersandsignplusmn;11.37) than in abdominal obese (mean__ampersandsignplusmn;SD-92.80__ampersandsignplusmn;1.16) at (p = 0.046*). Conclusion: IS based CVS responses are significantly different in the neck obese. It may be checked further using IS based SMI as a tool for other populations.