Changes that occur in the localization of calcitonin gene-related peptide-like-immunoreactivity (CGRP-LI) in motoneurons, following injury to the human spinal cord, were examined. CGRP-LI above and below the level of injury was compared to normal human spinal cord. Vibratome sections were cut and processed for immunostaining using the avidin-biotin immunoperoxidase method. Whereas motoneurons above the lesion contained CGRP-LI, below the lesion the CGRP-LI was reduced. In 3 spinal cords from patients who had survived between 1 and 8 years after injury, CGRP-LI in motoneurons of lumbar spinal cord was absent or considerably diminished. In the spinal cord from one patient who had died several years after injury, there was a unilateral augmentation of CGRP immunostaining. The results suggest that CGRP levels in motoneurons are affected by spinal cord injury in humans and that CGRP levels in motoneurons may be regulated either by supraspinal afferent inputs or by muscle activity.