An epidemiological survey of spinal cord injury in Okayama Prefecture was carried out by reviewing the registration lists contained in the Law for the Welfare of the Physically Disabled. The authors computed the annual incidence of spinal cord injuries (SCI) in Okayama Prefecture (April 1988-March 1989) to be 49.0 (28.6 for traumatic cases) per one million inhabitants from a population of 1,920,000. In addition, distribution by age, aetiology, paralysis level and residential area were investigated.