Eccentric (ECC) exercise training induces greater increases in muscle strength, hypertrophy and performance compared with work rate (WR) matched concentric (CON) exercise. During ECC WR-matched cycle ergometry there is also a reduction in cardiovascular (CV) and metabolic demands compared with CON. However, the magnitude of this reduction during ECC exercise, which more closely mirrors natural locomotion, is unknown. Similarly, it is unknown whether ECC stepping exercise performed at the same CON metabolic rate can be tolerated to allow a greater volume of work to be accumulated for the same CV and metabolic demand. PURPOSE: To compare CV and metabolic responses during CON and ECC stepping exercise performed at the same mechanical and metabolic rates. METHODS: Eight participants (5 m, 3 f), (mean ± SD: 22 ± 2 yr; 172 ± 6 cm; 70 ± 9 kg) performed a CON and ECC ramp incremental test to the limit of tolerance on a step ergometer (Eccentron; BTE, Hanover, MD, USA). CON and ECC constant WR tests were then performed for 15 min at the same mechanical (work) and metabolic (pulmonary oxygen uptake (VO2)) rate, set at 90% of the CON lactate threshold (i.e. moderate-intensity). All tests were undertaken > 48 hours apart. Breath-by-breath VO2, heart rate (HR), and blood pressure (BP) responses were measured throughout. RESULTS: During constant exercise at the same mechanical WR (36.2 ± 6.2 W), in which a steady-state was attained, compared with CON, ECC [INCREMENT]VO2 was 64 ± 9 % lower (22 ± 0.07 vs. 0.62 ± 0.17 l.min-1; P < 0.05), [INCREMENT]HR was 51 ± 13 % lower (14.6 ± 5.9 vs. 29.9 ± 7.2 beats.min-1; P < 0.05) and [INCREMENT] mean arterial pressure was 56 ± 18 % lower (7 ± 3 vs. 16 ± 5 mmHg; P < 0.05). The ECC WR predicted to match for metabolic rate (VO2, 1.2 ± 0.1 l•min-1) was 66 ± 19 % higher (60.0 ± 13.2 vs. 36.2 ± 6.2 W; P < 0.001), and allowed a greater volume of work to be accumulated; however, VO2 and HR continued to increase throughout the exercise. CONCLUSION: ECC stepping exercise at the same mechanical WR reduces the CV and metabolic demand of the exercise. Although ECC exercise at the same predicted VO2 was tolerable, and allowed a greater volume of work to be accumulated, VO2 and HR increased throughout the exercise, suggesting this was performed at a higher exercise intensity, which may be contraindicated in some populations.