Objective: The aim of this study was to examine the usefulness of a portable Internet-enabled ECG recording system (iECG) in monitoring the heart health of Japanese individuals working abroad. Methods: This study included 24 male Japanese individuals working abroad, who had been found to have risks of cardiovascular diseases (CVDs) at periodic health checkups. The subjects were instructed to send ECG recordings obtained by the iECG via a personal computer from their countries of residence. Interpretations of the ECG results were shared with the participant and the participant's occupational physician via e-mail. Further, a questionnaire survey was conducted among the subjects to determine the usefulness of the iECG. Results: Only 21 subjects (53.7 ± 5.2 years) could send their ECG recordings from their countries of residence. During the monitoring period (average, 0.7 ± 0.3 years), 504 ECG recordings were obtained using the iECG. No new CVD events were observed. The iECG monitoring recorded ST-T abnormality in 4 subjects (19%), ST-T abnormality plus left bundle branch block in 1 subject (5%), bradycardia in 1 subject (5%), atrial fibrillation in 1 subject (5%), short PR interval in 1 subject (5%) and normal findings in 13 subjects (61%). The questionnaire results showed a 68% rating for satisfaction, 58% rating for comfort, 68% rating for device utility and 37% rating for lifestyle improvements brought about by device use. Conclusions: The iECG could serve as a useful support tool for monitoring heart health in Japanese workers residing abroad with risk factors of CVDs.(J Occup Health 2014; 56: 387-392)