The present study investigated whether autonomic arousal to direct gaze is related to social impairments among children with autism spectrum disorder (ASD). Arousal was measured through skin conductance responses (SCR) while the participants (15 children with ASD and 16 control children) viewed a live face of another person. Impairments in social skills was assessed with the Developmental, Dimensional and Diagnostic Interview. The level of arousal enhancement to direct gaze in comparison to arousal to faces with averted gaze or closed eyes was positively associated with impairments in social skills (use of language and other social communication skills and use of gesture and non-verbal play) among children with ASD. There was no similar association among children without ASD. The role of arousal-related factors in influencing eye contact behaviour in ASD is discussed.