Objective: To investigate changes in lipid, lipoprotein and apolipoprotein pro®les in persons with spinal cord injury (SCI) during the ®rst 2 years post-injury, and to determine whether changes in risk pro®les were associated with sport activity and/or changes in physical capacity parameters. Design: Risk pro®les and physical capacity were investigated in 19 subjects with recent SCI during rehabilitation (t1) and +1 year after discharge from rehabilitation (t2). Main outcome measures: Changes in total plasma cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), apolipoprotein-A1 (ApoA1), apolipoprotein-B (ApoB) concentrations, the ratios TC/HDL-C, LDL-C/HDL-C, ApoA1/ApoB and HDL-C/ApoA1, and physical capacity (maximal isometric strength, sprint power output, maximal power output, aerobic power). Results: Risk pro®le parameters changed towards more favorable values at t2, except for HDL-C (P=0.06), TG and HDL-C/ApoA1. Sport activity and changes of the physical capacity were the most important determinants of changes in lipid and (apo)lipoprotein pro®les, showing more favorable values with larger increases of the physical capacity and in persons who were physically active. Conclusion: Results show that the lipid and (apo)lipoprotein pro®les improve in persons with SCI during the ®rst 2 years post-injury, and that improving the physical capacity or being physically active can improve the lipid and (apo)lipoprotein pro®les.