The muscle groups required for respiration include the diaphragm, intercostals, abdominal muscles, and accessory muscles. A SCI that occurs in the cervical or thoracic region can affect the nerves that innervate these muscles and, as a result, impair respiration. With a complete injury above C3, paralysis of these muscles usually requires lifetime ventilation for survival. People with incomplete or lower-level injuries are not as compromised but can still experience weakness or spasticity in the muscles that reduce respiratory flow rates and lung volumes (Galeiras Vázquez et al. 2013). Developing rigorous management and prophylactic protocols for respiratory complications are key to improving patient outcomes and preventing morbidity and mortality (Berney et al. 2011). This chapter discusses the interventions available to assist with respiratory management during the acute phase post-SCI. Broadly, the interventions are categorized into mechanical ventilation (MV), non-pharmacological interventions, pharmacological interventions, and secretion management.