A key word literature search for scientific articles published from January 1, 2014 to September 1, 2019 investigating acute neuroprotective management following spinal cord injury (SCI) was conducted using the following online databases: MEDLINE, CINAHL, Scopus, EMBASE and Cochrane Library. Population key words (i.e., spinal cord injury, paraplegia, tetraplegia, and quadriplegia) and neuroprotection key words (i.e., steroids, methylprednisolone, prednisolone, dexamethasone, GM-1 ganglioside, monosialotetrahexosyl ganglioside, corticosteroid, aminosteroid, nonglucocorticoid steroid, tirilazad, tirilazad mesylate, naloxone) were used in combination. The search was limited to English publications that were either journal articles, reviews or systematic reviews (excluding case reports) with at least three adults (≥18 years) with SCI. More than 50% of participants included in the study had to have a SCI, unless the results were stratified. Animal and pediatric studies, and case reports were omitted. It should be noted that articles were considered suitable for inclusion in this chapter if all, or the majority of, participants in each study were within approximately 3 months post SCI.