Objective To evaluate cardiac arrest outcomes following the introduction of the Australian Resuscitation Council (ARC) 2006 amended guidelines for basic and advanced life support. Methods A retrospective study of all consecutive cardiac arrests during a 3-year phase pre-implementation (2004-06) and a 3-year phase post-implementation (2007-09) of the ARC 2006 guidelines was conducted at a tertiary referral hospital in Brisbane, Australia. Results Over the 6-year study phase 690 cardiac arrests were reported. Resuscitation was attempted in 248 patients pre-implementation and 271 patients post-implementation of the ARC 2006 guidelines. After adjusting for significant prognostic factors we found no significant change in return of spontaneous circulation (ROSC) (odds ratio 1.21, 95% confidence interval 0.80-1.85, P = 0.37) or survival to discharge (odds ratio 1.49, 95% confidence interval 0.94-2.37, P = 0.09) after the implementation of the ARC 2006 guidelines. Factors that remained significant in the final model for both outcomes included having an initial shockable rhythm, a shorter length of time from collapse to arrival of cardiac arrest team, location of the patient in a critical-care area, shorter length of resuscitation and a day-time arrest (0700-2259 hours). In addition the arrest being witnessed was significant for ROSC and younger age was significant for survival to discharge. Conclusions There are multiple factors that influence clinical outcomes following an in-hospital cardiac arrest and further research to refine these significant variables will assist in the future management of cardiac arrests.