This communication evaluates the clinical efficacy of dexamethasone in acute spinal cord injury. The results of treatment in 290 patients given dexamethasone were compared with those of the control group of 330 patients not treated with corticosteroids. Patients with complete injuries and those with incomplete injuries showed greater improvement both quantitatively and qualitatively after treatment with dexamethasone than those without corticosteroids. The slightly increased risk of complications such as gastrointestinal bleeding and delayed wound healing was noted. It is recommended that corticosteroids should be used within the first hours after spinal cord injury.