Study design <p>A systematic review and thematic synthesis of qualitative studies.</p> Objective <p>To systematically explore and synthesize the telerehabilitation experiences and needs of patients with spinal cord injury (SCI).</p> Methods <p>Six databases were searched. Findings were reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines and the Joanna Briggs Institute (JBI) Reviewer’s Manual standards. Two reviewers independently screened studies, extracted data, and assessed quality using the JBI Critical Appraisal Tool for Qualitative Research. Data were synthesized using thematic synthesis, a core analytical approach for integrating findings from qualitative research to identify cross-study patterns.</p> Results <p>The search identified 15 eligible studies, including 12 qualitative studies and 3 mixed-methods studies (only qualitative data were extracted). A total of 286 participants were included comprising SCI patients, medical staff, and nursing staff. The synthesis yielded four core themes: participants’ attitudes toward telerehabilitation, perceived benefits, perceived barriers, and needs and expectations. For spinal cord injury patients with SCI, telerehabilitation offer multiple benefits alongside distinct challenges and unmet needs.</p> Conclusion <p>Telerehabilitation provides a promising option and novel experience for home-based rehabilitation in SCI patients. Professionals should take full account of patients’ perspectives, offer diverse and effective support, address individual needs, enhance the practicality, technical performance, and accessibility of telerehabilitation, and continuously work to improve patient outcomes.</p>