Motor vehicle traffic crashes (MVTCs) are the leading cause of traumatic spinal cord injury. Evidence of putative risk factors for this type of injury comes largely from descriptive studies. This study is the first case-control study of risk factors for spinal cord injury specifically in car crashes. Cases of occupant spinal cord injury in South Australia were identified from the Australian Spinal Cord Injury Register (ASCIR) which provides full coverage of the adult population. The comparison group was other seriously injured car occupants. In single vehicle car crashes in the country, the likelihood of spinal cord injury was five times higher for occupants of non-sedan type cars compared with sedans. The likelihood of spinal cord injury was especially high in non-sedan type cars involved in rollover crashes; ten times higher than sedans. The implications of the findings for prevention are highlighted. Concern is expressed over the increasing proportion of four wheel drive passenger vehicles (sport utility vehicles) in the car fleet in Australia, and in the USA, as they are more prone to rollover.