This chapter summarizes pioneering work on neural tissue transplantation that showed the feasibility of cell replacement as a treatment for spinal cord injury (SCI). It focuses on neural transplants with emphasis on the potential for neural stem cells (NSCs) and lineage-restricted precursors to replace damaged neurons and glia and to enhance regeneration. NSC has been identified not only in the fetal central nervous system (CNS), but also at later stages of CNS development and in select regions of the brain and spinal cord throughout adult life. The chapter present results of their transplantation into the spinal cord with respect to issues of fate, potential therapeutic properties and problems that need to be solved. It considers strategies for activating endogenous stem cells in the adult spinal cord for repair. Finally, the chapter reviews experimental strategies for cellular replacement in traumatic injury.