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Context/Objective: The examination for Spinal Cord Injury (SCI) Medicine subspecialty certification has been administered since 1998, but published information about exam performance or administration is limited.Design:Retrospective reviewSetting/Participants: We examined de-identified information from the American Board of Physical Medicine and Rehabilitation (ABPMR) database for characteristics and performance of candidates (n = 566) who completed the SCI Medicine Examination over a 10-year period (2005–2014), during which the exam outline and passing standard remained consistent.Interventions:Not applicableOutcome Measures: We analysed candidate performance by candidate track, primary specialty, number of attempts, and domains being tested. We also examined candidate perception of the SCI Medicine Exam by analysing responses to a survey taken after exam completion.Results: Thirty-six percent of candidates who completed the exam during the study period took it for initial certification (23% in the fellowship track and 13% in the practice track offered during the initial “grandfathering” period) and 64% took it for maintenance of certification (MOC) in SCI Medicine. Factors associated with better exam performance included primary specialty certification in Physical Medicine and Rehabilitation (PM&R) and first attempt at passing the exam. For PM&R candidates, ABPMR Part I Examination scores and SCI Medicine Examination scores were strongly correlated. Candidate feedback about the exam was largely positive with 97% agreeing or strongly agreeing that it was relevant to the field and 90% that it was a good test of their knowledge.Conclusion:This study can inform prospective candidates for the SCI Medicine Examination as well as those guiding them. It may also provide useful information for future exam development.