A non-governmental organization that helps low-income, rural, indigenous Guatemalans to have free or low-cost surgical care found that fewer than 60% of their patients kept their surgical appointments. The objective of this study was to identify the factors that predict compliance with scheduled surgery. All 690 surgical candidates screened by this organization between April 2008 and March 2009 and scheduled for surgery by August 2009 were included in this analysis. For the 474 adult patients the best predictors of compliance included a shorter time between screening and surgery, knowing someone who has had surgery, and several indicators of low socioeconomic status. For the 216 pediatric patients the best predictors of compliance included a shorter time between screening and surgery, having a parent who speaks Spanish in addition to the local indigenous language, and having a parent who knows someone who has had surgery. These findings suggest that the best ways to improve surgical attendance are to schedule surgery as close to the screening date as possible and to ensure that surgical candidates and their families meet a local resident who has had surgery.