AIM: This paper is a report of a study to explore health problems, physical and mental functioning, and physical activity in working-age patients after myocardial infarction, in order to assess the possible effects of these factors on return to work. BACKGROUND: A diagnosis of myocardial infarction may discourage patients from continuing an active working life. Enabling myocardial infarction patients to return to work has benefits for both individuals and society. METHODS: A convenience sample was recruited of 88 patients, <or=65 years of age, who had suffered a myocardial infarction. Assessments of employment, health-related quality of life and physical activity (footsteps per day) were conducted in 2005-2006, 4-6 months after myocardial infarction. To explore data and compare groups, t-tests were applied. Logistic regression analyses were performed to identify variables that best predicted return to work. RESULTS: Differences were identified between individuals who were employed after myocardial infarction and those who were not. Those not in work scored lower on variables related to the physical dimension of health-related quality of life and on physical activity. Logistic regression revealed that a multivariate model including age, physical dimension of health-related quality of life and footsteps per day predicted return to work in 68% of all cases (R2=0.344). CONCLUSION: Low physical health and low physical activity after myocardial infarction negatively affect returning to work. These findings stress the importance of clinical assessment of myocardial infarction patients' daily physical activity and physical functioning.