OBJECTIVES: Effort investment during listening varies as a function of task demand and motivation. Several studies have manipulated both these factors to elicit and measure changes in effort associated with listening. The cardiac pre-ejection period (PEP) is a relatively novel measure in the field of cognitive hearing science. This measure, which reflects sympathetic nervous system activity on the heart, has previously been implemented during a tone discrimination task but not during a speech-in-noise task. Therefore, the primary goal of this study was to explore the influences of signal to noise ratio (SNR) and monetary reward level on PEP reactivity during a speech-in-noise task. DESIGN: Thirty-two participants with normal hearing (mean age = 22.22 years, SD = 3.03) were recruited at VU University Medical Center. Participants completed a Dutch speech-in-noise test with a single-interfering-talker masking noise. Six fixed SNRs, selected to span the entire psychometric performance curve, were presented in a block-wise fashion. Participants could earn a low (€0.20) or high (€5.00) reward by obtaining a score of ≥70% of words correct in each block. The authors analyzed PEP reactivity: the change in PEP measured during the task, relative to the baseline during rest. Two separate methods of PEP analysis were used, one including data from the whole task block and the other including data obtained during presentation of the target sentences only. After each block, participants rated their effort investment, performance, tendency to give up, and the perceived difficulty of the task. They also completed the need for recovery questionnaire and the reading span test, which are indices of additional factors (fatigue and working memory capacity, respectively) that are known to influence listening effort. RESULTS: Average sentence perception scores ranged from 2.73 to 91.62%, revealing a significant effect of SNR. In addition, an improvement in performance was elicited by the high, compared to the low reward level. A linear relationship between SNR and PEP reactivity was demonstrated: at the lower SNRs PEP reactivity was the most negative, indicating greater effort investment compared to the higher SNRs. The target stimuli method of PEP analysis was more sensitive to this effect than the block-wise method. Contrary to expectations, no significant impact of reward on PEP reactivity was found in the present dataset. Also, there was no physiological evidence that participants were disengaged, even when performance was poor. A significant correlation between need for recovery scores and average PEP reactivity was demonstrated, indicating that a lower need for recovery was associated with less effort investment. CONCLUSIONS: This study successfully implemented the measurement of PEP during a standard speech-in-noise test and included two distinct methods of PEP analysis. The results revealed for the first time that PEP reactivity varies linearly with task demand during a speech-in-noise task, although the effect size was small. No effect of reward on PEP was demonstrated. Finally, participants with a higher need for recovery score invested more effort, as shown by average PEP reactivity, than those with a lower need for recovery score.