The development in the understanding of the pathophysiological processes leading to SCI effects is overwhelming. As explained in this chapter, the pathophysiology after SCI is a complex process with distinctly identified stages. However, the interaction between these processes at different stages is not yet fully understood. Nevertheless, the understanding so far forms the basis on which enormous promising strides have been possible towards treatment in SCI. The modest functional improvements thus obtained from the experimental therapies clearly indicate the need for further understanding of the complex pathophysiological process of human SCI. It is also important to bear in mind the differences in animal and human trials and should have a vigilant enthusiasm about the recent developments.