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Approximately 17,000 new spinal cord injuries occur each year in the United States, with motor vehicle collisions and falls being the most common causes. Even though 94% of patients survive the initial injury and corresponding hospitalization, their life expectancy is reduced secondary to the long-term complications that stem from their injury. Every patient should be approached in the same manner (i.e., as if they have a spinal cord injury) until proven otherwise to prevent additional injury. Important considerations that should take place in the emergency department include the patient's airway, the presence of shock, and the prevention of complications secondary to the primary injury. This article briefly summarizes the epidemiology and pathophysiology of spinal cord injuries and the therapies that may be recommended and initiated following a thorough assessment of the patient.