Spinal cord injury is a major medical problem because there currently is no way to repair the central nervous system and restore function. In this chapter, we focus on embryonic stem cells as an important research tool and potential therapy. We quickly review the epidemiology, functional anatomy, and pathophysiology of spinal cord injury and then discuss spontaneous regeneration and current limitations on repair. We also summarize features of spinal cord development that might guide restoration strategies. We then review studies that have utilized embryonic stem cells in spinal cord repair. We conclude that progress has been good, that knowledge is still too limited, and that harnessing the potential of embryonic stem cells will be important for solving the problem of spinal cord injury. © 2014 Elsevier Inc. All rights reserved.