Aim: Little is known regarding work status long-term after heart transplantation (HT). The purpose of this study was to examine demographic and clinical characteristics of patients who were working and not working, and to identify factors associated with working patients at five and 10yr post-HT. Methods: Data from patients (78% male, 88% white, mean age=53.8yr) at four US sites using the following instruments: Post-op Work History, Sickness Impact Profile (SIP), Quality of Life Index, Cardiac Depression Scale, and chart review were used. Statistical analyses included t-tests and logistic regression. Results: The percentage of working patients at fiveyr remained steady over time to 10yr post-HT. Using the SIP, working patients had less overall, physical, and psychosocial functional disability at fiveyr. Working patients at five and 10yr had significantly less depression than non-workers. Working patients at fiveyr had fewer co-existing illnesses than non-workers. Predictors of working at five and 10yr included demographic, psychosocial, and clinical variables. Conclusion: Understanding rates of return to work and factors associated with return to work may assist clinicians as they discuss working after transplant with patients during evaluation for transplant and develop interventions to assist post-transplant patients who want to return to work. © 2011 John Wiley & Sons A/S.