Purpose <p>This study aimed to investigate the relationship between tissue bridges and bladder and bowel outcomes in chronic cervical spinal cord injury (SCI).</p> Methods <p>Between July 2020 and January 2024, 44 patients with chronic cervical SCI were retrospectively included in this cross-sectional study at a specialized SCI center. Lesion severity was assessed by tissue bridges, lesion length, lesion width, and lesion area. Bladder and bowel outcomes were evaluated with Spinal Cord Independence Measure (SCIM), International Standards to Document Autonomic Function following SCI, and Geffner-Gonzalez-Santacruz-Flor Bladder Function Scale. Patients were categorized as independent bladder management or bladder dysfunction based on SCIM. Correlation analysis was applied to investigate associations between lesion severity and clinical outcomes. Binary logistic regression analysis and receiver operating characteristic (ROC) curve analysis were conducted to identify crucial factors and critical values for independent bladder management.</p> Results <p>In chronic cervical SCI, the width of tissue bridges was positively associated with bladder and bowel outcomes, while lesion length, lesion width, and lesion area showed negative associations (<i>P</i> &lt; 0.05). Binary logistic regression analysis identified tissue bridges as a protective factor for independent bladder management (<i>P</i> &lt; 0.05). ROC analysis indicated that tissue bridges larger than 1.80&#xa0;mm may allow for independent bladder management (<i>P</i> &lt; 0.01).</p> Conclusion <p>The width of tissue bridges was associated with bladder outcomes. These findings suggest that tissue bridges may potentially provide valuable insights for bladder management in patient counseling and personalized treatment plans.</p>