Study design: Prospective population-based open-ended study. This paper is part of the Stockholm–Thessaloniki Acute Traumatic Spinal Cord Injury Study. Objectives: To calculate incidence and evaluate the epidemiological profile of the incident population with traumatic spinal cord injury (TSCI). Settings: The greater Thessaloniki region in Greece and the greater Stockholm region in Sweden. Methods: TSCI individuals, older than 15 years of age, who had survived the first 7 days post-trauma, were identified through an active surveillance system. The forms of the Nordic Spinal Cord Injury Registry were used. Results: 87 individuals were injured in the greater Thessaloniki and 49 in the greater Stockholm region. Annual crude incidence was 33.6 per million for Thessaloniki and 19.5 per million for the Stockholm region. The leading causes of injury for the Thessaloniki region were transportation accidents (51%) and falls (37%), and those for the Stockholm region were falls (47%) and transportation accidents (23%). A significantly larger number of individuals of the Thessaloniki group were injured in transportation accidents. There was no significant difference between regions with regard to the type of resulting impairment. Conclusions: Incidence of TSCI was considerably higher in the Thessaloniki region as compared with that in the Stockholm region, probably chiefly reflecting differences in preventative measures with regard to driving.