Examined the neuroendocrine parameters associated with decision-making deficits in pathological gamblers. A computerized decision-making task with explicit rules for gains and losses (Game of Dice Task, GDT) was completed by a sample of 22 male patients with pathological gambling (PG, mean age 40 years, under psychotherapeutic treatment) and 19 healthy men (mean age 43 years). Salivary levels of cortisol and alpha amylase (sAA) were assessed immediately before as well as 10, 20, and 30 minutes after the task. Compared to controls, patients showed severe decision-making deficits. In contrast, neither group showed any changes in cortisol and sAA levels during the testing procedure. Correlation and subgroup analyses, however, revealed an increase of sAA levels only in PG patients who showed less disadvantageous decision-making patterns. These results are assumed to indicate the differential activation of somatic markers in PG patients: Those making more advantageous choices may be prevented from choosing risky alternatives by somatic markers as reflected in higher levels of sAA. Furthermore, possible reasons for the lack of cortisol responses are discussed.