© 2014 Elsevier Inc. Background Spinal imaging plays a critical role in the diagnosis, treatment, and rehabilitation of patients with spinal cord injury (SCI). In recent years there has been increasing interest in the development of advanced imaging techniques to provide pertinent microstructural and metabolic information that is not provided by conventional modalities.Methods This review details the pathophysiological structural changes that accompany SCI, as well as their imaging correlates. The potential clinical applications of novel spinal cord imaging techniques to SCI are presented.Results There are a variety of novel advanced imaging techniques that are principally focused on the microstructural and/or biochemical function of the spinal cord, and can potentially be applied to traumatic SCI, including diffusion tensor imaging, magnetic resonance spectroscopy, positron emission tomography, single-photon emission computed tomography, and functional magnetic resonance imaging. These techniques are presently in various stages of development, including some whose applications are primarily limited to laboratory investigation, whereas others are being actively used in clinical practice.Conclusion Advanced imaging of the spinal cord has tremendous potential to provide patient-specific physiological information about the status of cord integrity and health. Advanced spinal cord imaging is still at early stages of development and clinical implementation but is likely to play an increasingly important role in the management of spinal cord health in the foreseeable future.