In order to determine any beneficial effects of parenteral steroid administration and local cord cooling following complete cord injury, ten patients in the present series were treated by a combination of these modalities within 8 1/2 hours after injury. There was a better than expected rate of recovery of motor function and sensation and the mortality rate was reduced compared with more traditional forms of therapy. A literature review showed that local cord cooling had been applied to 52 patients with complete cord injuries in various centers. The rate of neurologic improvement was 48%, the ambulation rate was 17% and the 1-year mortality rate was reduced to 17%. These figures appear considerably better than the comparable expected rate for traditional treatment of such injuries. The results are encouraging enough to suggest further trials of treatment using localized cord cooling where such treatment can be instituted within 4 hours following injury.