In South Africa, epidemiological data on spinal cord injury (SCI) are scarce, partly owing to the lack of a national registry and a coordinated system of care. A recent study by Joseph et al. provided the first population estimates of the incidence of traumatic spinal cord injury (TSCI), reporting a staggering rate of 75.6 per million persons. The main cause of TSCI in South Africa was found to be assault, which accounted for approximately 60% of all cases, followed by transport-related causes (26%) and falls (12%). 1 This recent report provides an optimal platform for prevention because of its population-based design; however, the data only represent the City of Cape Town and not the entire nation of South Africa. The only other epidemiological study of South Africa, conducted 2 decades ago in Johannesburg, found similar mechanisms of injury 2 but a lower incidence rate that is probably due to the hospital-based design. Taken together, the 2 studies show a disproportionately high incidence of violent injuries in South Africa, compared to the rest of the world, which is believed to be precipitated by the sociopolitical climate. 2,3 With regard to prevalence and mortality of TSCI, and nontraumatic spinal cord injury, (NTSCI) generally, there are no available reliable reports, although the QuadPara Association of South Africa estimated in 2009 that approximately 50,000 people in South Africa are living with an SCI. 4 With the restructuring of the health care system in South Africa, moving toward a universal health insurance, it is essential to firmly establish the epidemiological profile of SCI to redistribute resources for improved service delivery. Many gaps concerning the epidemiology of TSCI and NTSCI remain, especially for mortality and life expectancy after SCI.