Abstract Objective Voxel-mirrored homotopic connectivity (VMHC) has been studied in several neuropsychiatric illnesses. The inter-hemispheric interactions probably could explain the important aspects for the pathophysiology of panic disorder (PD). Therefore, we initiated this study to estimate the differences in VMHC values between the PD patients and controls. Methods Thirty first-episode medication-naïve patients with PD and 21 controls were enrolled with age and gender controlled. All the participants received the scanning of resting-state functional magnetic resonance imaging (R-FMRI). The R-FMRI images were preprocessed and analyzed to obtain the VMHC values. The two-sample t test of VMHC data between PD patients and controls was performed. We also explored the relationship between the VMHC values and clinical characteristics. Results The controls had significantly higher VMHC values than patients in the posterior cingulate cortex and precuneus (false discovery rate corrected p<0.005). The one-sided results by the unilateral hemisphere mask also confirmed that the results were indeed found in the right hemisphere. The VMHC value in the posterior cingulate cortex was also negatively correlated with panic severity. Conclusion The alterations of inter-hemispheric coordination in cingulate-precuneus may play a role in the pathophysiology of PD.