Purpose To gain in-depth understanding of the number and type of experienced ageing problems, obstacles to perform work tasks, retention factors to maintain work and support needs to continue working life in the next years among workers aged 45 years and older with and without a chronic health condition. Methods A survey of workers' perspectives on problems, obstacles, retention factors and needs due to ageing was carried out in 3,008 workers aged 45 years and older in nine different companies. To classify the open-ended questions we used the International Classification of Functioning and disability (ICF). Results Older workers with a chronic health condition reported more problems due to ageing (56 vs 34 %; p <.001), more obstacles (42 vs 16 %; p <.001) and more needs (51 vs 31 %; p <.001) compared to those without a chronic health condition. No relevant differences were found on type of experienced problems, obstacles, retention factors and needs between both groups. Problems and obstacles were found on physiological and psychological functions. Retention factors and needs to enhance sustainable working life were particularly reported on work-related environmental factors. Conclusion Because workers with a chronic health condition experienced more problems, obstacles and needs, the largest gain of occupational intervention can be achieved in these workers. However, our findings suggest that interventions aimed to enhance sustainable working life of older workers can be similar in content for persons with and without chronic health conditions and should have a central focus on work-related factors. © 2013 Springer Science+Business Media New York.