Severe spinal cord injury (SCI) is a very debilitating injury. This report presents information from the Australian Spinal Cord Injury Register (ASCIR) on 374 newly incident cases from trauma and disease in the year 2005-06. During the year, 284 new cases of SCI from traumatic causes were registered in Australia, an age-adjusted incidence rate of 15.7 cases per million population. The most common clinical outcome of SCI was incomplete tetraplegia (93 cases). Transport related injuries (46%) and falls (33%) accounted for over three-quarters of the 284 cases of traumatic SCI. Cases also occurred during sport (n=35) and working for income, including travel to and from work (n=43). Falling was the most common type of event leading to traumatic SCI at older ages. The ASCIR is a collaborative activity of the AIHW National Injury Surveillance Unit and all of the specialist spinal units in Australia.