Of 144 patients with spinal cord injury admitted to the Sunnybrook Medical Centre from 1974 to 1979, 25 (24 men) (17.4%) had sustained their injuries at work. The 25 patients ranged in age from 20 to 56 years, with more than half being in their third decade of life. Work-related spinal cord injury was more frequent in the thoracic region than spinal injuries from other causes. The injuries were generally severe, 24% of them being complete cord injuries (i.e., no sensory or motor function below the level of injury). The mean neurologic grade of these patients did not change substantially between the time of admission and discharge. The mortality was 8%. The pattern of spinal cord injury in this series was compared to that in the period 1948 to 1973, when 105 (29.3%) of 358 spinal cord injuries occurred at work, constituting the second most frequent cause of acute spinal cord injury, after traffic accidents. In the current series, only 17.4% sustained their injuries at work. This was the third most common cause of spinal injuries in this period after traffic accidents and sports-recreational injuries. Falls in industry were the most frequent mode of work injury from 1974 to 1979, compared with construction accidents in the earlier period. The number of work-related spinal cord injuries is still too high. Furthermore, the severe neurologic damage suffered and the lack of substantial improvement emphasize the importance of preventive efforts, especially in industry. The fact that work injuries now rank third as a relative cause of spinal injury may indicate an absolute decline in this type of injury, especially among construction workers.