Abstract Background Rehabilitation needs are rising worldwide. The World Health Organisation recognises that many countries are not equipped to meet existing rehabilitation needs and has issued a call to action; Rehabilitation 2030 encouraging countries to focus on rehabilitation as a health priority. We sought to identify the rehabilitation needs of patients admitted to a tertiary hospital, measure the complexity of rehabilitation needs, and identify appropriate setting to meet these needs. Methods All admitted patients were identified using the electronic patient admissions system on February 17th, 2023. Patients under the care of emergency medicine were excluded. Data was collected by teams of two healthcare professionals familiar with rehabilitation. Data collected: demographics; most appropriate location of care—Hospital, Community, Rehabilitation Unit; Clinical Frailty Score (CFS); Rehabilitation Complexity Score (RCS); estimated Length-of-Stay (LoS). Results 640 patients identified. Median age was 71. 42% (269/640) >75 years, 47% (127/269) CFS 4–6, 16% (43/640) CFS 7–9. 12% (78/640) identified as having rehabilitation needs best met in a rehabilitation unit. Rehabilitation needs were identified across specialities, majority identified in Medicine 36% (28/78), and Stroke 28% (22/78). Average RCS 9.4, max RCS 18. Highest average RCS 12 identified in Neurosurgery patients. 3% (33/640) estimated LoS of >3 months, 30% (10/33) with primary rehabilitation needs. Average RCS 12.71 in patients with estimated LoS 3–4 months, 12 in LoS > 4 months. Conclusion Our study identifies significant and complex rehabilitation needs in the acute hospital setting. Rehabilitation needs were diverse across specialities, with certain areas showing increased complexity of needs and longer estimated lengths of stay. Increased numbers of specialist rehabilitation beds are needed to ensure patients rehabilitations needs are optimised.