Periodic health checkups constitute an important public health strategy to prevent the onset of diseases and promote healthy behaviors. However, adherence to recommendations to undergo further medical examination after annual health checkups is not necessarily high. This study examined the factors related to adherence to recommendations among Japanese employees. We conducted a cross-sectional study of 219 employees who had ignored recommendations to visit a physician for the previous 3 yr; we assessed their work- and life-related factors, health status, and health literacy. We analyzed the data of 103 employees who met the inclusion criteria. Participants who lived alone and had a primary doctor, lower job demand, and lower self-rated health were significantly more likely to adhere to recommendations, suggesting that work- and life-related factors—rather than individual health literacy—may be more important. Further study is needed toward effective utilization of annual health checkups in the workplace.