Background: Cardiovascular diseases (CVDs) are the most common cause of mortality and morbidity worldwide and are a significant public health problem in low- and middle-income countries (LMICs), including Bangladesh. The prescribed cardiovascular rehabilitation (CR) has well-known survival benefits, but uptake has remained low with numerous barriers to access, such as a lack of awareness. This study aimed to evaluate patients’ insights, understanding, and perception of obstacles to CR in a tertiary healthcare hospital in Bangladesh. Methods: This cross-sectional observational study was conducted at Bangladesh Medical University from June to December 2023. Convenience sampling was used to recruit 90 adult patients with cardiovascular conditions. A structured questionnaire on CR awareness, perceived benefits, and barriers to participation was used to collect the data. Descriptive statistics was used to analyze the demographic variables, knowledge, and response patterns. Results: Only 45.6% of participants were aware of the CR program, whereas healthcare providers were a significant source of information (45.6%). The most frequently recognized benefit was improved quality of life (67.8%), followed by decreased risk of recurrent cardiac events (65.6%). The primary barriers to CR participation were financial (30.0%), time (27.8%), and family support (23.3%) constraints. Conclusions: Limited knowledge and numerous barriers stand in the way of CR in Bangladesh. Strategies to improve CR utilization and cardiovascular health outcomes include enhancing patient education, increasing accessibility, and implementing financial and social support strategies.