Spinal cord injury (SCI) is a devastating condition that affects multiple bodily systems, leading to significant hematological and endocrinological complications. The systemic inflammatory response following SCI often results in infections, impaired healing, increased risk of thrombotic events, and osteoporosis, with these complications not always detectable through standard blood tests. The hypothalamic–pituitary–gonadal and thyroid axes may also be disrupted, causing hormonal imbalances that exacerbate obesity, muscle mass loss, and fertility issues. Hematologically, SCI disrupts the autonomic network, leading to abnormal sympathetic and neuroendocrine responses, including the expansion and impaired mobilization of hematopoietic stem and progenitor cells. This dysfunction increases the risk of deep venous thrombosis (DVT) and pulmonary embolism (PE), with factors such as immobility, hypercoagulability, and venous intimal injury playing key roles. In the chronic phase, prevention strategies for thromboembolic events remain ambiguous, necessitating a tailored approach that includes anticoagulation, physical therapy, and possibly the use of vena cava filters. Endocrinologically, SCI significantly impacts bone metabolism, leading to a higher incidence of osteoporosis and fragile fractures, particularly in the distal femur and proximal tibia. Hormonal changes, mechanical unloading, and sarcopenia are critical factors in this bone loss. Metabolic complications such as insulin resistance and hyperlipidemia are prevalent, contributing to a chronic inflammatory state and increased cardiovascular risk. Effective management of these conditions involves a combination of pharmacological treatments, physical therapy, and lifestyle modifications, with ongoing research needed to refine prevention and treatment strategies for this complex patient population.