Objectives: To determine predictors of satisfaction with care and symptoms in patients with acute low back pain 1 year after presentation to primary care. Methods: The study is a secondary analysis of an existing cohort study of 1343 patients with acute low back pain presenting to primary care. Participants presenting to general practitioners, physiotherapists, or chiropractors were assessed at the initial consultation and followed up over 12 months. Putative predictors of patient satisfaction were extracted from baseline questionnaires. Multivariate logistic regression models were developed to predict satisfaction with care and satisfaction with symptoms at the 12-month follow-up. Results: Most patients were highly satisfied with the care received (76%) and a smaller proportion with their symptoms (55%) at 12 months. Pain intensity at 12 months had a strong association with both measures of satisfaction. After controlling for the level of pain intensity, those born outside Australia, older people, and those reporting more symptoms of depression were less likely to be satisfied with the care received. Patients reporting poor general health at the initial visit and more symptoms of depression were less likely to be satisfied with their symptoms at the 12-month follow-up. Discussion: Pain intensity at the 12-month follow-up has a strong association with patient satisfaction. Primary care practitioners should remain aware of the influence of cultural, demographic, and psychological factors on satisfaction with care and symptoms.