This chapter has well written text and 3 well illustrated diagrams and pictures showing spinal injuries. Suspicion to spinal injury, pathology, clinical presentation, investigations, management of spinal injury are given in detail. Fracture of occipital condyles, axis vertebra, atlas vertebra, atlantoaxial dislocation are described comprehensively. Canadian c-spine rule, spinal injury grading system, spinal shock, spinal cord neuropraxia, spinal injury syndrome, cauda equine syndrome, central cord syndrome are explained with tables and diagrams. 154 references are given for further reading to conclude this chapter.