Objectives:We evaluate the level of anxiety and depression among patients with spinal cord injury (SCI) in relation with their religious coping and spiritual health. Setting: Brain and Spinal Cord Injury Repair Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Methods: A sample of patients with SCI participated in this cross-sectional study. They completed a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale, the Brief Religious Coping Questionnaire and the Spiritual Well-being Scale. Then, the association between anxiety, depression and independent variables was examined. Results: In all, 213 patients with SCI were studied. Of these, 64 (30%) have had anxiety and 32 (15%) have had depression. Multiple logistic regression analyses revealed that gender (odds ratio (OR) for female = 3.34, 95% confidence interval (CI) = 1.31-8.51, P = 0.011), employment (OR for unemployed = 5.71, 95% CI = 1.17-27.78, P = 0.031), negative religious coping (OR = 1.15, 95% CI = 1.04-1.28, P = 0.006) and existential spiritual well-being (OR = 0.93, 95% CI = 0.89-0.97, P = 0.003) were significant contributing factors to anxiety (Table 3), whereas negative religious coping (OR = 1.21, 95% CI = 1.06-1.37, P = 0.004) and existential spiritual well-being (OR = 0.90, 95% CI = 0.84-0.96, P = 0.001) were significant contributing factors to depression. Conclusion: The findings indicated that depression and anxiety are two psychologically important side effects after SCI. The findings also indicated that religion and spiritual well-being have a moderating role on occurrence of depression and anxiety.