Background Repetitive transcranial magnetic stimulation (rTMS) is increasingly used in research. However, cardiac safety is not routinely assessed. Objective This study aims to investigate cardiac safety of rTMS in people with a bulimic eating disorder. Methods Thirty-eight people with a bulimic disorder were enrolled in a randomized sham-controlled trial. High frequency rTMS was delivered to the left dorsolateral prefrontal cortex. Results rTMS did not alter blood pressure or heart rate. Conclusions Our findings indicated that this rTMS paradigm has no cardiac complications as assessed by blood pressure and heart rate. This adds to the emerging literature on the cardiac safety of rTMS. (C) 2011 Elsevier Inc. All rights reserved.