Given that traumatic spinal cord injuries (SCI) often occur among young, previously well nourished individuals, a decline in nutritional status most likely occurs after the injury. These declines are the result of the combined effects of altered metabolism and a change in lifestyle practices. Many secondary complications of SCI are related to changes in energy, glucose, lipid and vitamin metabolism, including undesirable weight gain, cardiovascular disease (CVD) risk, insulin resistance and osteoporosis. Additional nutrition-related complications which can negatively impact quality of life include pressure ulcers and neurogenic bowel and bladder. Little is known about the most effective health promotion activities, including nutrition interventions, required to promote long-term wellness for persons after a SCI. However, it is clear that adequate nutrition following SCI will help reduce the likelihood of further morbidity associated with post-SCI physiological and metabolic changes. This chapter will summarize what is currently known regarding nutrition issues in the post-acute SCI population.