Spinal cord injury (SCI) remains a global concern for which there is no cure. This special issue of Cells Tissues Organs presents possible engineering approaches to circumvent various aspects of SCI. It presents topics related to bioelectric medicine and ultrasound as well as their potential ability to interface with or regenerate neural tissue. Additionally, several biomaterial-related issues are presented, including hydrogel selection with a special emphasis on swelling and intraspinal pressure, the use of nanoparticle technology in the spinal cord, and fibrous materials for neural stem cell implantation and drug delivery. Two ground-breaking articles highlight the importance of considering oligodendrocyte response in engineering approaches and modulation of the inflammatory response following SCI. Engineering Approaches to Spinal Cord Injuries is of special interest to clinicians who wish to translate up-and-coming research areas to the clinic, basic researchers collaborating with engineers, and the engineers themselves. The reader will become aware of promising approaches that may in the future become vital to the treatment of SCI.