As noted in the other SCIRE chapters, physical activity and specifically, leisure time physical activity (LTPA) has multiple physiological and physical benefits for individuals with spinal cord injury (SCI). In recent years, studies have examined the benefits of LTPA on psychological and participation-related outcomes. The present chapter aims to describe the research that examined the role LTPA plays on psychological outcomes, namely anxiety and depression, quality of life (QOL), and participation. We review the evidence on the relationship between LTPA and these outcomes among observational and longitudinal studies, as well as describe the effectiveness of LTPA interventions on enhancing these outcomes.