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Background Inpatient cardiac rehabilitation (Phase 1 CR) has been commonly used to educate patients and facilitate early engagement for subsequent outpatient CR programmes, however its impact on UK hospital re-admissions has not been well studied.Aim Ascertain whether Phase 1 CR is associated with reduced rates of re-hospitalisations.Methods Patients with a diagnosis of acute coronary syndrome and relevant treatment in Sandwell and West Birmingham NHS Trust (SWBH) during 2018–2025 were identified via hospital records. Subsequent patient encounters with the local CR team were also determined in terms of phase 1 and first CR outpatient assessment (CRCAS), coupled to the incidence of hospital all-cause re-admissions during the period between hospital discharge and CRCAS.Results Nine thousand, six hundred and sixty-eight patients were identified. Patient data (N=799) attained during the height of the Covid-19 pandemic (03/20 to 05/21) was excluded from analysis. Hospital re-admission rates were lower amongst patients who had had Phase 1 CR (Gr1) compared to those who had not had (Gr2) (Gr1; N=5313, 16.7% vs Gr2; N=3555, 22.8%. P=0.0058). Attendance rates to the CRCAS were also significantly higher in Gr1 (97.3%) compared to Gr2 group (78.5%; P<0.0001).Conclusion Attendance of Phase 1 CR was associated with reduced rates of readmissions and improved attendance of the first CR assessment, however the time elapsing from hospital discharge until the first outpatient encounter needs to be considered. More research to elucidate the effect of Phase 1 CR on hospital re-admissions and patient engagement is warranted.