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Cardiovascular rehabilitation is a key multidisciplinary intervention in patient recovery after cardiac events such as acute myocardial infarction. Despite evidence of its benefits in reducing morbidity and mortality, adherence to cardiovascular rehabilitation programmes remains suboptimal. Psychosocial factors, including illness perception, coping styles, and lifestyle behaviours, have been identified as critical determinants of adherence. This study aims to explore the role of psychosocial factors in adherence to a cardiovascular rehabilitation programme among post-acute myocardial infarction patients. Specifically, the study seeks to: (1) describe psychosocial factors and adherence levels; (2) analyse differences based on sociodemographic and clinical variables; and (3) identify associations between psychosocial factors and cardiovascular rehabilitation adherence. This quantitative, descriptive study included 55 Portuguese participants. Data were collected using a Sociodemographic Questionnaire, the Brief Illness Perception Questionnaire, the Brief COPE, and a Lifestyle Scale. A higher perception of personal control was significantly associated with adherence (p = .005, d = .78). Regular physical exercise before acute myocardial infarction was also linked to better adherence (p = .021, V = .312). Women showed significantly healthier lifestyle behaviours than men (p = .002, d = 1.179). No significant associations were found for other variables. Perceived personal control and prior exercise are key to cardiovascular rehabilitation adherence. Gender differences highlight the need for personalised interventions.