Introduction Cardiac rehabilitation (CR) programs are essential for the recovery and secondary prevention of cardiovascular diseases. Despite the proven benefits of such programs, participation and completion rates remain suboptimal. This systematic review aims to identify literatures that systematically analyse and synthesize the factors and barriers influencing patients’ participation in cardiac rehabilitation programs.

Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used. Initial keywords for the precise search were based on the Boolean operators. A comprehensive literature search was conducted across PubMed, ScienceDirect, Cochrane Library, ProQuest, and Scopus databases. Studies on factors and barriers influencing patients’ participation in cardiac rehabilitation programs were included in the review. Data extraction and quality assessment were performed independently by two reviewers. The data were assessed for methodological quality using a Critical Appraisal Skills Program (CASP) checklist.

Results A total of 10 studies met the inclusion criteria, encompassing a diverse range of populations and settings. Commonly identified factors and barriers include logistical/distance issues, financial issues, time constraints, health status, and transportation issues. Barriers related to the healthcare system, such as inadequate referral processes and insufficient patient education, were also found to be significant.

Discussion This review focuses on the barriers influencing patient participation in CR programs regardless of the phase. As the selected studies cover both developing and developed nations, the results of this current study can be generalized across various countries. The most prominent CR barriers are related to logistical, financial, and psychosocial factors.

Conclusions Multiple factors and barriers hinder patients’ participation in cardiac rehabilitation programs. Addressing these barriers through targeted interventions is vital to enhance patients’ engagement and improve the efficacy of cardiac rehabilitation programs. Future research should focus on developing and evaluating strategies to overcome these obstacles.