Abstract Background and Purpose. This study looked at adherence, and factors affecting adherence, to a prescribed home exercise program (HEP) in older adults with impaired balance following discharge from physical therapy. Subjects. The subjects were 556 older adults (≥65 years of age) who were discharged from physical therapy during the period 2000 to 2003. Methods. A survey was developed to determine participation in a HEP. Univariate logistic regressions identified specific barriers and motivators that were associated with exercise participation following discharge from physical therapy. Results. Ninety percent of respondents reported receiving a HEP; 37% no longer performed it. Change in health status was the primary reason for poor adherence to a HEP. Eight barriers (no interest, poor health, weather, depression, weakness, fear of falling, shortness of breath, and low outcomes expectation) were associated with a lack of postdischarge participation in exercise. Discussion and Conclusions. Exercise adherence following discharge from a physical therapy program is poor among older adults. Barriers, not motivators, appear to predict adherence. [Forkan R, Pumper B, Smyth N, et al. Exercise adherence following physical therapy intervention in older adults with impaired balance.