Study design: This cross-sectional study was conducted by comparing bone mineral density (BMD) of paraplegic and quadriplegic patients. Objectives: The purpose of this study was to investigate the relationship between the bone mineral loss and injury level in spinal cord injury patients. Settings: Experiments were conducted at Yoneda Hospital and Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan. Methods: Lumbar spine (L2-4), proximal femur (femoral neck, trochanter region and Ward's triangle) and whole body BMD were measured in ten paraplegic and ten quadriplegic patients using dual-energy X-ray absorptiometry (DXA, HITACHI BMD-1X). Results: Signi®cant di erences were observed in the lumbar spine, trochanter region and upper extremities BMD between paraplegic and quadriplegic patients (P50.05, P50.05 and P50.01, respectively), but not in the femoral neck, Ward's triangle, head, pelvis, lower extremities or whole body BMD. Conclusion: These results suggest that the injury level in¯uences on the lumbar spine, upper extremities and trochanter region BMD. From a biomechanical standpoint, it is possible to explain that the di erences in mechanical loading exerted on bones also a ected the di erence of lumbar spine BMD in the two groups.