The aim of this study was to examine the effect of Reiki in patients with cardiac disease. This study was a single-blind, pre-post-test, randomized, placebo-controlled study. Patients from the cardiology outpatient clinic of a training and research hospital were randomized into three groups: Reiki (n = 22), sham (placebo) (n = 21), and control (no treatment) (n = 22). Data were collected using a personal information form, biochemical parameters, cortisol levels, Beck Anxiety Inventory, and electrocardiography analysis. The Reiki group received Reiki to nine main points for 30 min, while the sham Reiki group received the same points during the same period without starting the energy flow. On Day 2, distance Reiki was performed for 30 min. After 1 week, the researchers administered the Beck Anxiety Inventory, assessed the biochemical parameters and cortisol levels, and analysed the electrocardiography again. Of the patients, 52.3% were male and 47.7% were female, and the mean age (years) was 60.45 ± 9.67 years. The control group had a significantly higher post-test cortisol level than the other groups (P = 0.002). According to the post hoc analysis, there was a significant difference between the Reiki vs. control groups and sham vs. control groups (P = 0.002). The control group had a significantly higher post-test cortisol level than the pre-test cortisol level (P = 0.008). Reiki group had a significantly lower mean post-test Beck Anxiety Inventory score than the other groups (P < 0.001). There was no difference between the electrocardiography results of the groups (P > 0.05). Reiki reduces blood cortisol levels and anxiety levels in patient with cardiac diseases. ClinicalTrials.gov: NCT05483842.