The rate of suicide following spinal cord injury appears to be greater than in the general population. 6 patients who died by suicide, from a total of 342 patients who were treated for acute spinal cord injury over a 5-year period are described. Clinical features of this group of patients include being male; having schizoid, depressive or narcissistic personality traits; substance abuse; significant others who favoured death as a preferred option; & the development of significant depression.