**Abstract**

Neurogenic shock is a state characterized by hypotension, bradycardia, and other evidence of autonomic dysfunction. The most common cause is acute spinal cord injury (SCI), which will be the subject of our focus. Because the typical autonomic reflexes may be either abolished or dysregulated, appropriate treatment requires an understanding of the neuroanatomic substrate for the change. In this chapter, we will explore the root cause for neurogenic shock, differentiating it from spinal shock, and discuss those patients at risk and generally accepted treatment paradigms. The timeframe for manifestation of neurogenic shock is variable and it can quickly progress to cause secondary injury or death, so appropriate monitoring requires a high level of suspicion and diligence.

**Keywords:** neurogenic, shock, hypotension, bradycardia, hypothermia, autonomic, sympathetic, vasomotor, dysreflexia, spinal cord
