Background: Motor vehicle trauma and falls are common causes of injury to the spine and spinal cord in Tanzania. These injuries cause paralysis, sensory loss and render the patient profoundly disabled and dependant. Adversities or mishandling in pre-hospital care are known to cause additional cord damage and worsen function in up to 25% of cases. Primary and secondary prevention strategies are key factors to consider in order to improve outcome in developing countries. Objective: To assess pre-hospital transport factors and the impact of other spinal injury factors (such as: level of spinal injury, stability of the spine fracture and associated injuries) on the type and severity of neurological impairment. Materials and Methods: Data on traumatic SCI patients aged from 16 years were collected prospectively. Neurological assessment was performed according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) and plain X-rays examined. Results: There were 36 patients with male preponderance (91.7%). Spine immobilization was done to any of the patients and only three patients (8.3%) were transported by ambulance. Baseline neurological status was graded as complete (41.6%) and incomplete injury (58.4%). Instability of the vertebral segments and associated injuries were significantly associated with severity of neurological impairment (P˂0.05). Conclusion: These data showed that a significant number of patients had a complete SCI and pre-hospital transport was of poor quality.