This chapter explores the role of spinal cord reflexes as valuable adjuncts to traditional neuromonitoring techniques, offering crucial insights into the sensory and motor functions of the spinal cord, sacral nerve roots, and specific peripheral nerves. It focuses on three primary reflexes—Hoffman (H) reflex, bulbocavernosus reflex (BCR), and external urethral sphincter reflex (EUSR)—which can be readily incorporated into clinical practice. The chapter discusses the utility of these reflexes in assessing neural pathways, highlighting their contribution to a comprehensive approach in spinal cord and nerve root monitoring.