Purpose To explore work related and personal facilitators and barriers for return to work (RTW) and stay at work after stroke. Materials and methods Twenty individuals post-stroke (median age 52 years; seven women) were interviewed in focus groups. Data were analyzed by using qualitative content analysis. Results An overall theme “Work conditions, support and changed personal priorities influenced RTW and stay at work after stroke” emerged and covered three categories: “Adjustments and flexibility at the work place facilitated RTW and a sustainable work situation”, “Psychosocial support and knowledge about stroke consequences facilitated work and reduced stress”, and “Changed view of work and other personal priorities”. Physical adjustments at the work place and flexibility in the work schedule were perceived facilitators. Support from family and colleagues were important, whereas lack of knowledge of stroke disabilities at the work place was perceived a barrier. Also changed personal priorities in relation to the work and the current life situation influenced RTW in various ways. Conclusions The individual’s opportunities to influence the work situation is a key factor for RTW and the ability to stay at work after stroke. Adjustments, flexibility, support, knowledge of stroke, and receptivity to a changed view of work are important for a sustainable work situation. Implications for rehabilitation Physical adjustments at the work place, a flexible work schedule and support increase the individual’s possibility to RTW and maintain a sustainable work situation after stroke. Changed work and life priorities after a stroke need attention in the RTW process. Rehabilitation professionals have an important role in providing knowledge about the disabilities following stroke, and how they impact work ability. Individually tailored recommendations for work place adjustments which enable RTW and a sustainable work situation are warranted.