Spinal cord injuries (SCIs) are serious injuries that can have a profound impact on the lives of athletes and their families. Although rare, the most common mechanisms of SCIs in sports include axial loading, hyperflexion, hyperextension, and compressive forces. The signs and symptoms of an SCI can vary depending on the level of the lesion and the severity of the injury. The long-term effects of SCIs can also be significant and can include physical, emotional, and social challenges. This chapter is intended for athletic trainers, coaches, and other healthcare professionals who work with athletes. Athletic trainers play a critical role in the prevention, assessment, and management of athletes and SCI. The information in this chapter provides an overview of the mechanisms, pathophysiology, signs, and symptoms, and long-term effects can help identify athletes who are at risk for SCIs. The athletic trainer’s role in providing emergency care to athletes who sustain an SCI and in promoting the prevention of SCIs in sports is also outlined.