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Mindfulness-based interventions (MBIs) are evidenced to be effective for a range of physical and psychological health problems for the clinical and non-clinical population. However little is known about engagement in MBIs. In order to address this research gap, this thesis begins with a meta-analysis exploring the relative odds of engaging in an MBI intervention in comparison to other active interventions (Paper 1). Although the findings were inconclusive, as most papers included in the meta-analysis reported study dropout data only, a key issue identified in this paper was the lack of a consensual definition on engagement in MBIs. Papers 2 to 4 aim to develop a coherent definition of engagement in MBIs and identify the factors associated with it. Due to the paucity of research in engagement in MBIs this thesis starts with a bottom-up approach exploring qualitatively the experience of engaging in a self-help 8-week MBI (Paper 2). This paper identifies several key hindrances of engagement in MBIs. The most striking of these hindrances is habitual perseveration. This reflects a key contradiction as MBIs are theorised to reduce perseverative habits such as rumination and worry. Paper 3 explores this empirically and supports the paradox of engagement in MBIs that rumination and worry are barriers of engagement in MBIs. In addition, two facets of engagement in MBIs, physical and psychological, are identified. In order to understand if rumination and worry are hindrances to engagement in any interventions, Paper 4 explores the model of engagement identified in Paper 3 in comparison to an active control condition. In conclusion, this thesis defines engagement in MBIs and identifies some factors associated with engagement. Implications for treatment and future research directions are discussed.