Severe spinal cord injury is a very debilitating injury. This report presents information from the Australian Spinal Cord Injury Register on 381 cases from trauma and disease in 2004-05. During the year, 280 new cases of spinal cord injury from traumatic causes were registered in Australia, an age-adjusted incidence rate of 15.4 cases per million population. The most common clinical outcome of spinal cord injury was incomplete tetraplegia. Falling was the most common type of event leading to traumatic spinal cord injury at older ages. The Australian Spinal Cord Injury Register is a collaborative activity of the AIHW National Injury Surveillance Unit and all of the specialist spinal units in Australia.