Pressure ulcers are a major complication of patients with spinal cord injury (SCI) and have a significant effect on general health and quality of life. Pressure ulcers in persons with SCI, while similar to other high-risk populations, have some important differences. Standard risk assessment may not be effective in persons with SCI and prevention efforts must be focused differently. As most pressure ulcers in persons with SCI are community acquired, prevention must be targeted on early detection, behavior change strategies, and social networks. This session will examine the pathophysiology of pressure ulcer development in the patient with SCI and issues specific to this population including: recurrence, altered anatomy, risk assessment, and prevention.