The aim of the study was to gain insight into the associated risk factors for restraint use in older adults with home care. A cross-sectional survey of restraint use was conducted in a randomized sample of older adult home care patients completed by the patients’ primary care nurses. A binary logistic regression model with generalized estimating equations was used to evaluate associations with the presence of restraints. Of the 8000 questionnaires, 6397 could be used for further analysis. Patients had a mean age of 80.6 years, 66.8% were females and 46.4% lived alone. 24.7% was restrained. Multivariate regression indicates that restraint use was associated with supervision [OR = 2.433, 95% CI = 1.948 - 3.038]; dependency in ADL-activities (i.e. eating [OR= 2.181, 95%, CI= 1.212 – 3.925], difficulties in transfer [OR= 2.131, 95%, CI= 1.191–3.812] and continence [OR= 1.436, 95%, CI= 0.925 – 2.231]); perceived risk of falls by nurses’ clinical judgement [OR= 1.994, 95%, CI= 1.710 – 2.324], daily [OR 1.935, 95%, 1.316–2.846] and less than daily [OR= 1.446, 95%, CI= 1.048–1.995] behavioral problems; decreased well-being of the informal caregiver [OR= 1.472, 95% CI= 1.126 - 1.925]), the informal caregiver’s dissatisfaction with the support of family [OR= 1.339, 95% CI= 1.003 - 1.788]; cognitive impairment [OR= 1.398, 95% CI= 1.290 - 1.515], and polypharmacy [OR= 1.415, 95% CI= 1.219 - 1.641]. Restraint use in home care is very common. The results may support the development of interventions to reduce restraint use in home care.