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Introduction: Spinal cord injury (SCI) is a debilitating disease. Bone marrow stem cells (BMSCs) have a high potential to regenerate the nerve lesion but have low survival. The use of artificial scaffolds to increase the survival of cells and strengthen their effects had not good results due to the lack of biologically active substances and the effects of immunogenicity and biocompatibility. The extracellular matrix of natural tissue is a good candidate to overcome these problems. The purpose of this research was using the natural adipose tissue extracellular matrix (AdECM) to enhance the regenerative effects of BMSCs in rat spinal cord injury. Methods and Materials: Extracellular matrix were extracted from rat abdominal fat tissue by physical-chemical method. Then it was converted into a hydrogel using pepsin. Bone marrow stem cells from rat femur extracted and cultured, third passage used for the experiment. One week after the creation of contusion model spinal cord lesion in rats, 10 µl of AdECM hydrogel and one million BMSCs were injected in the spinal cord lesion area. Then the animals were evaluated by behavioral tests for 8 weeks. At the end of the eighth week, an electrophysiological examination was performed and spinal cord tissue samples were extracted, stained and histologically performed on them. Results: The findings showed that AdECM strengthens the regenerative effects of BMSCs. These effects include further reduction of histological signs of spinal cord injury, increase in GAP43 protein expression and enhancement of sensory and motor recovery in rats. Conclusion: These findings suggest that AdECM is a useful natural scaffold for efficient treatment of spinal cord injury. [ABSTRACT FROM AUTHOR]