Cardiovascular disease (CVD) is the leading cause of death and disability for women and men. Substantial health risks continue following ischemic coronary events (ICEs), but secondary prevention efforts, including cardiac rehabilitation (CR), have beneficial effects on both early and late mortality and morbidity. This prospective study examined the relationship among psychosocial factors and CR referral and participation patterns in 906 (586 men, 320 women) patients from the coronary intensive care unit (CICU) over the course of six months. Only 30% of participants were referred to CR programs, with significantly fewer women being referred. A logistic regression analysis was used to determine whether depression, anxiety, self-efficacy, or social support predicted CR participation six months following an ICE, while controlling for sociodemographic factors. Results show that higher family income, greater anxiety symptomatology, and higher self-efficacy were significantly predictive of CR participation at six months. Implications for women's recovery from an ICE are discussed.