Study design <p>Cohort study.</p> Objectives <p>To investigate the dynamic and changing course of subjective well-being (SWB) over 20 years among people with chronic spinal cord injury.</p> Setting <p>Medical university in the Southeastern United States.</p> Methods <p>1568 individuals from three hospitals completed a self-report assessment (SRA) in 2003 and were followed four times over 20 years. Among them, 372 responded to the most recent follow-up in 2023. Participants met the following inclusion criteria: traumatic SCI of at least 1-year duration, minimum of 18 years of age, and residual impairment from SCI (noncomplete recovery). We used the Life Situation Questionnaire-Revised (LSQ-R) to assess nine aspects of subjective well-being. The multilevel models were applied to both 1568 individuals’ sample and 372 individuals’ sample to identify trajectories for each of the nine aspects of subjective well-being over 20 years.</p> Results <p>All the nine subscales of LSQ-R had either moderate or substantial test-retest stability over 20 years. The sample of 1568 individuals presented longitudinal changes for all three life satisfaction subscales, and for four life problem subscales. Among the sample of 372 individuals, only one life satisfaction subscale and four life problem subscales showed significant longitudinal changes.</p> Conclusions <p>Our findings indicate that there was a mixed pattern of SWB changes over time, notably indices of home life satisfaction and economic situation appeared to improve over time, while at the same time their health problems and feeling of social isolation increased.</p>