Given the mixed findings concerning self-determination theory in explaining adherence to exercise referral schemes (ERS), the present study attempted to examine whether autonomous motivation and psychological need satisfaction could predict ERS adherence. Participants referred to an 8-week ERS completed self-report measures grounded in self-determination theory and basic needs theory at baseline (N=124), mid-scheme (N=58), and at the end of the scheme (N=40). Logistic regressions were used to analyse the data. Autonomous motivation measured at mid-scheme explained between 12% and 16% of the variance in ERS adherence. Autonomy, relatedness and competence measured at mid-scheme explained between 18% and 26% of the variance in ERS adherence. This model also explained between 18% and 25% when measured at the end of the scheme. The study found limited evidence for the role of autonomous motivation in explaining ERS adherence. Stronger support was found for the satisfaction of the three needs for autonomy, relatedness and competence in predicting ERS adherence. Future research should tap into the satisfaction of all three needs collectively to help foster ERS adherence.