Objectives: Generally, it is difficult for elderly patients with acquired brain injuries (ABI) to return to work (RTW). To assess whether elderly patients with ABI can return to their workplace, like working-age patients, we investigated medical and support records and compared the rates of RTW between the working-age and elderly groups. Methods: A prospective cohort study on RTW among inpatients with ABI was conducted. We collected the clinical data of inpatients who were admitted to the Department of Neurosurgery for acute treatment and participation in a health and employment support program; follow-ups were conducted after discharge. Participants with almost independent activities of daily living (ADL) were enrolled. A χ2 test was used to examine factors influencing RTW and successful RTW by groups stratified by white-collar and blue-collar occupations and hemiplegia. The Kaplan-Meier method was used to calculate the RTW proportion curves. Results: The RTW rates were 74% for the working-age group and 89% for the elderly group (χ2 test, p=0.149); age was not a significant factor. Occupation type was the only significant factor for RTW (χ2 test, p=0.014). The RTW proportion curves of both the working age and elderly groups showed early RTW, and the elderly group had a significantly higher RTW profile than the working-age group (log-rank test, p<0.039). Almost all elderly participants were engaged in white-collar or less physical jobs, to which it is easy to return. Conclusions: In participants with almost independent ADL, the elderly group had a higher RTW rate than the working-age group.