Spinal cord injury (SCI) is an incurable neurotraumatic catastrophe that afflicts mostlyyoung individuals with resultant functional impairment of varying degrees of severity.The single pharmacologic treatment option at present is systemic methylprednisolone administration within 8 hours postinjury oftentimes accompanied by neurosurgical interventions. As a rule, SCI becomes a chronic condition with significant handicap for the patient and socioeconomic repercussions for the affected families and health care system. Important discoveries in the field of central nervous system regeneration sincethe early 80’s have led to diverse potential therapeutic approaches for neuroprotectionand repair. Unfortunately, most envisioned treatment apporaches would only be applicable at the acute and subacute stages of SCI, thereby excluding the large patient base with chronic SCI. Future treatments will have to address the complexity of SCI with a multipronged approach in order to effect the appropriate type and degree of immunomodulation, achieve neuroprotection, and promote collateral sprouting and axonal regeneration ultimately resulting in tissue repair and functional recovery.