Abstract: Objective To investigate the effect of music therapy on eye movement characteristics of joint attention (JA) in children with autism spectrum disorder (ASD), providing an objective basis for clinical intervention. Methods A randomized crossover design was adopted. Twenty-six children with ASD aged 3–10 years were enrolled and randomly assigned to group A or B. Participants received either music therapy intervention or a quiet sitting control condition, and after a 7-day washout period, the experimental conditions were switched. Eye-tracking technology was used to record time to first fixation (TFF) and total fixation duration (TFD) during a joint attention paradigm task under three conditions: eyes only, eyes-head, and head-eyes-gesture. Paired-sample t-tests were employed to compare the effects of music intervention. Results After music therapy, TFF in the head-eyes-gesture condition was significantly shorter than that in the quiet sitting control condition (t = –2.32, p = 0.030, Cohen’s d = –0.485). TFF under all conditions combined was also significantly shorter compared to the control (t = –2.24, p = 0.035, Cohen’s d = –0.458). Although differences in the eyes-only and eyes-head conditions did not reach statistical significance, the mean TFF was shorter in the music therapy condition.? Conclusion Music therapy can significantly shorten the time to first fixation on joint attention targets in children with ASD, suggesting that it may improve core social deficits by enhancing neural information processing efficiency. Eye movement characteristics may serve as an objective indicator for evaluating the efficacy of music therapy.