Evidence is accumulating that many persons with spinal cord injury also have acquired brain injury. The investigation reported here included a comprehensive neuropsychological assessment of 89 persons admitted to university hospitals for treatment of acute spinal cord injury. Between one-fourth and one-half of the subjects demonstrated impairment in most areas of cognitive functioning. Findings are consistent with those of prior investigations. These results have important implications for clinical practice; however, uncertainties exist about the exact etiology of cognitive impairments, and further research is needed to elucidate their origin.