Erythromycin lactobionate (ERY), a macrolide antibiotic, has been the focus of investigati on as a new gastrointestin al prokinetic agent. In individuals who are able-bodied (AB), ERY has shown promise in various form s of gastroparesis (GP). Recent evidence suggests th at med ica tions used to stimu late intestinal motility in individuals who are AB have had similar results in those individuals with spinal cord injury (SCI). M ed ica tions th at have been used in th e past for GP in SCI include metaclopramide, neostigmin e, and bethanechol.In thi s observation, a pati ent with T-6 para pl eg ia, who deve loped GP secondary to acute SCI, is presented. During his hosp ital stay, th e p ati ent was treated with gastric decompress ion, bowel rest, H2 blockers, intrave nous metaclopramide, and ventua ll y required parenteral nutritiona l support. ERY was started and symptom s abated. At thi s point, the nasogastri c tube was r mov d and oral feeding was success fully started. This case report is th e first to describe a pati nt with refractory SCI -induced GP who respo nded to intraveno us ERY. Further study in thi s area is warranted.