Objectives: The purpose of this study was to determine cardiac rehabilitation (CR) referral following percutaneous coronary intervention (PCI) compared to the National average, and identify barriers for referral that may be unique to an academic medical practice.Background: National guidelines recommend CR following PCI as a class I indication due to proven benefits.Multiple recent publications reveal poor utilization of CR.Overall; only 58% of the eligible patients in the US are referred to CR.Barriers include physicians referral pattern, and patient factors.We hypothesize that application of current knowledge of CR benefits and barriers to referral would result in increased referral to CR following PCI, and due to its unique location to serve a large catchment area in rural Georgia, distance to CR facility will be a major barrier to the referral.Methods: Data was analyzed from 376 eligible patients undergoing PCI procedures performed at the Medical College of Georgia, Augusta from November 1, 2008, through October 31, 2009.We collected demographic information on all patients, identified factors in both groups (referred/not referred) and used chi-square tests to determine level of significance.Results: Mean age was 61.4±11.0 yrs; 58.5% were men, 35.9% African Americans, 47.6% smokers; 68.1% had insurance, 43.6% diabetes; 91.0% hypertension and 71.5% dyslipidemia.In this population, only 18.4% were referred for CR.Those not referred lived a mean distance of 43.8±36.8 miles compared to 26.2±27.0 miles for those referred (p<0.001).Age, sex, race and insurance status were not significant in comparing those referred with those not referred (p>0.05).We did not find any documentation stating reason for non-referral in all 81.6% patients.This signifies a physician factor resulting in poor CR referral.Conclusion: Our findings for referral to CR following PCI are well below the National average.Distance from the facility and physician factors were the major barriers for CR referral.Better measures are needed to improve CR referral.Involvement of physician extenders in discharge planning may improve referral.These findings suggest exploration of alternate strategies to CR for those residing far away from the facility.