Spinal cord injury (SCI) is one of the most debilitating injuries that a person can suffer. Australia was the first country to implement a national population-based register of SCI to enable surveillance and help prevent and control this problem. This report provides information for 1999-00 from this register. During the year, there were 261 new cases SCI in Australia. Approximately one-third of these arose from motor vehicle accidents, a third of which were due to motor vehicle rollover. Falls were a significant cause of SCI in the elderly. Thirteen cases arose from aquatic activities, including diving. Forty-four cases were work related. The most common outcome was incomplete tetraplegia (82 cases), indicating a significant level of dysfunction in both the upper and lower limbs.