Return to work (RTW) is an important outcome following disc herniation surgery. The present study aimed at determining factors that may affect early RTW after disc herniation surgery. Data were collected from 603 patients who underwent disc herniation surgery in an educational hospital via phone interviews during a 4-year period (2005-2009). Delayed RTW and failed RTW were associated with female gender, lower educational levels, longer hospitalization periods, greater BMI, biological age exceeding 40 years, employment in manual labor, lack of encouragement by the physician to RTW, being in pain at the time of the phone interview, having negative expectations about the outcome of surgery preoperatively, and low job satisfaction (P < .05). Psychological and occupational factors have direct effects on RTW. Important factors include positive expectations about the outcome of surgery, encouragement by the physician to RTW, job characteristics, and job satisfaction. RTW can be accelerated by appropriate strategies and team work.