In order to encourage enrollment in cardiac rehabilitation exercise programs, it is essential to understand the perceptions of both enrollers and non-enrollers. Factors influencing enrollment in a cardiac rehabilitation exercise program in a northern centre in Canada servicing a large rural area were examined. Letters of invitation to participate in the program were sent to 30 cardiac patients who had enrolled in the program as well as to 30 patients who had met medical clearance criteria and were eligible to participate but who had not enrolled. Responses were obtained from 20 enrollers and 9 non-enrollers. Participants completed a questionnaire developed by the investigators and then took part in a semi-structured interview. Both quantitative and qualitative data revealed physician recommendation as an influential factor for enrollment in the cardiac rehabilitation exercise program. Encouragement from family and friends and access to transportation also emerged as important factors for enrollers. The results of the study may assist health care professionals to increase enrollment in cardiac rehabilitation programs through education and provision of encouragement by appropriate individuals.