Beginning with the onset of spinal cord injury (SCI), there is a significant increase in the use of health care resources to deal with the immediate emergency and acute consequences of the injury. Later the focus shifts toward management of the individual’s disability, maximizing their abilities and treating ongoing secondary complications. To provide individuals with SCI with optimal care on the pathway to recovery, clinicians, health care facility administrators and policy decision-makers must have the best evidence to provide optimal care in a cost-effective manner. Evidence for health care interventions comes in many forms. For clinicians, the appropriateness of an intervention is often determined by its clinical efficacy and safety. Health care administrators or policy decision makers may additionally consider ethical and economic evidence. The focus of this review is on the economics evidence for SCI.