Background/Objectives: The physiological basis underlying symptomatic versus asymptomatic premature ventricular contractions (PVC) remains poorly understood. However, symptomatic PVC can significantly impair quality of life. In patients without structural heart disease, symptom intensity is crucial for guiding management strategies and determining the need for medical or surgical intervention. In this study, we aimed for the first time to examine the associations be-tween PVC symptoms and cardiac interoception. Methods: The study included 34 participants with PVC (20 women; median age = 42 years; 17 participants had asymptomatic PVC) without concomitant disorders. Interoception was assessed through interoceptive accuracy (IA) probed by two behavioral tests—mental tracking (MT) and heartbeat detection (HBD)—and the neurophysi-ological marker of cardiac interoception, the heartbeat-evoked potentials (HEPs). Symptom inten-sity scores reported by patients served as the response variable in the regression analysis, with IA and HEP as predictors. Other factors such as sex, age, percent of body fat, trait anxiety, and alexithymia were added to the models as confounding variables. Results: IAMT was significantly higher in patients with symptomatic PVC. IAMT and HEP modulation for the HBD task were asso-ciated with symptom intensity. A combined regression model incorporating both metrics showed the highest predictive accuracy for symptom severity. Adding confounding variables improved model quality (lower AIC); however, only the male sex emerged as a significant negative predictor for symptom intensity. Conclusions: Our findings confirm a significant association between in-teroception and PVC symptom severity. Integrating behavioral and neurophysiological interocep-tion measures enhances symptom prediction accuracy, suggesting new ways to develop diagnos-tic and non-invasive treatment strategies targeting interoception in PVC management.