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Spinal cord injury (SCI) almost always results in a decrement in functioning over the lifespan. With the lack of specialized SCI services in low- to middle-income countries and the trend of shorter stays in rehabilitation facilities following SCI, a definite need exists to empower clients to manage themselves, often while they await critical services or as they attempt to expand their functioning frameworks. Self-management (SM) is now a common term used in many health promotion and patient education intervention programs designed to help individuals manage their symptoms, treatment, physical and psychological consequences, and lifestyle changes inherent in living with a chronic condition such as SCI. This chapter aims (1) to describe spinal cord injury and its consequences, (2) to identify self-management intervention programs and associated skills as well their effectiveness on SCI outcomes, and (3) to highlight the need of integrating self-management programs into existing health systems in resource-constrained settings. Goal setting, action planning, problem-solving, decision-making, coping strategies, and resource utilization are critical tools in SCI self-management. Although the self-management interventions identified seemed to be cost-effective, the use of self-management in low- to middle-income countries is limited, indicating that self-management is not yet fully included in health care systems despite the evidence of its empirical support and potential utility. Therefore, there is a need to advocate the adoption or contextualization of promising available self-management programs into existing health systems in resource-constrained settings.