Spinal cord injury (SCI) is a severe central nervous system disorder with a high rate of disability and mortality. It is typically caused by traumatic vertebral burst fractures, with common causes including traffic accidents, falls from a height, and slips. After injury, patients often experience loss of motor and sensory functions, and may develop a variety of complications, such as respiratory dysfunction, cardiovascular dysfunction, neuropathic pain, muscle spasms, neurogenic bladder, and gastrointestinal dysfunction. These complications not only cause significant physical and psychological distress to patients but also severely impact their quality of life and prognosis. Early surgical intervention may salvage neural function, while rehabilitation training is also the essential therapeutic approach. The management of complications requires close collaboration among multidisciplinary teams. Effective preventive and therapeutic measures can significantly alleviate pain of patients and prolong survival. In recent years, with the deepening understanding of the pathophysiological mechanisms of SCI, clinical strategies for managing complications have been updated continuously. The application of new therapeutic methods and novel treatment strategies has brought hope for improving the quality of life of patients. This review summarizes the latest research progress on early complications of SCI, aiming to provide references for clinicians to optimize treatment plans and improve the quality of life for patients.