OBJECTIVE: Peer support facilitates patients and caregivers in adjusting to long-term disabilities. This study aimed to determine which patient characteristics are related to need for peer support during rehabilitation after acquired brain injury (ABI) and investigate factors that explain whether peer support is perceived as meaningful or not. DESIGN: A prospective cohort study over a period of 17 months following patients with ABI during inpatient rehabilitation in the Netherlands. Multivariable logistic modelling was applied to identify patient and intervention characteristics that were related to (1) need for peer support and (2) whether or not peer support was perceived as meaningful. Additional information on duration and subjects of conversation was reported. SETTING: Peer support was provided during inpatient rehabilitation. PARTICIPANTS: 120 patients with ABI >/=18 years were included and assessed at admission, 94 patients were assessed at discharge. Seventy-three percent (n=88) expressed a need for peer support and at discharge 76.6% (n=72) perceived contact as meaningful. RESULTS: Non-Western and single patients perceived a significantly higher need for peer support. Patients younger than 60 and those with time between ABI and discharge of >3 months perceived their contact significantly more meaningful. CONCLUSIONS: Results provide more insight into characteristics of patients with ABI who may benefit from peer support during inpatient rehabilitation. Optimal dosage, length of contact, rehabilitation phase and strategy for the provision of peer support should be investigated as well as the effects for ABI survivors on outcomes such as coping, self-efficacy, depression and health-related quality of life.