We cover two recent review papers on the topic: “An Update on Spinal Cord Injury and Current Management” by Carroll et al in the October 2024 JBJS Reviews, and “Updates in the Early Management of Acute Spinal Cord Injury” by Lambrechts et al in the September 1, 2023 issue of JAAOS. Urgency of spinal decompression, controversies with methylprednisolone, emerging neuroprotective and regenerative therapies, and optimizing spinal cord perfusion are covered.