Spinal cord injury was first described by the Ancient Egyptians who concluded that it was ‘an ailment not to be treated’. This attitude to spinal cord injury continued through succeeding centuries as a number of physicians described the pathology and consequences. Nursing input was not a feature of spinal cord injury management. In the 20th century the foundations of modern spinal cord injury care were laid out by pioneers such as Donald Munroe in the USA and Sir Ludwig Guttmann in the UK, during the Second World War. The nursing role in spinal cord injury care has developed since those days, but there is scope for nurses to develop that role further as new challenges are presented.