This study concerns spinal cord injuries (SCI) in a region of Portugal with a population of 1,721,650 inhabitants. Legislation has made it possible to identify deaths occurring during collection and transport. Between 1989 and 1992, 398 new cases of spinal cord injuries were identified, of which 77% were male and 23% female. The average age was 50, with a range of between 1 and 92. As far as the type of injury is concerned, there were 154 isolated SCI (38.7%); in 120 cases (30.1%) there were multiple associated injuries; in 66 cases (16.6%) there was an associated traumatic brain injury; in 34 cases (8.5%) there was an associated trauma of the thorax. In the hospitals concerned no Injury Severity Score (ISS) was carried out during hospitalization. Sixty-four (16%) were dead upon arrival at hospital, and 159 (40%) died before release. The average length of hospitalization was 26.6 days, with the maximum being 539 days. The annual incidence rate is 57.8 new cases per million inhabitants, including those who died before being admitted to hospital. The annual survival rate is 25.4 new cases per million inhabitants. The death rate is very high during the first week, peaking during the first 24 h.