A vehicle sound output device including: an acquiring section configured to acquire wakefulness level information that indicates a degree of a wakefulness state of a driver of a vehicle； and a control section configured to, in a case in which the degree of the wakefulness state indicates a decreased level of wakefulness, control a sound output section to output a sound based on at least one of a predetermined frequency, a predetermined tone, or a predetermined content that stimulates a sympathetic nerve of the driver.
