Background. Early medical rehabilitation (EMR) of the patients with spinal cord injury is discussed in this article. For successful rehabilitation adequate surgical treatment, which enables early verticalisation, is compulsory. Predictable respiratory, vascular, intestinal and urologic complications, contractures and bed sores are described and algorhytms of EMR in the period of spinal shock and after, until transferring the patient to the IRSR, are presented. Respiratory therapy, thromboprophylaxis, kinesiotherapy and functional electrical stimulation as well as the methods of early bladder and bowel control, contractures and bed sores prevention, as procedures of EMR are fully presented. With special importance early verticalisation from the 5th post operative day with help of the tilt table is presented as the key point of EMR. Conclusions. With aggressive EMR the paraplegic patient is able to gain erect posture from the 5th post operative day, sits in a wheel chair from 10th to 14th day and stands in the paralel bar from 15th day on.