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Occupational therapists are an essential healthcare profession and play a vital role in rehabilitating patients in the activities of daily life. Nevertheless, many occupational therapists in Sweden are leaving the profession and this jeopardises occupational therapy services. To explore factors that cause occupational therapists to seriously consider leaving their profession. As part of a larger national study of Swedish occupational therapists' health and work environment, qualitative content analysis with a summative approach was applied to explore the reasons for considering leaving their profession among 1279 Swedish occupational therapists. Three themes emerged: (1) facing work environment deficiencies, (2) pursuing own development and (3) Personal factors and external constraints. The largest category, belonging to theme 1, was stress and high work pressure given 344 times as a reason to consider leaving the profession. This article provides new and important insights on the reasons why occupational therapists may seriously consider leaving their profession. The results are significant for managers and employing organizations to consider in order to prevent a shortage of occupational therapy services. [ABSTRACT FROM AUTHOR]