Spinal cord injury (SCI) is a lifelong condition requiring integrated hospital-based and community-based rehabilitation services to support the individual from acute injury to long-term community living. In Australia, transitional rehabilitation has been used to support the transition from hospital to home for people with SCI,1, 2 providing multidisciplinary rehabilitation using a client-centred and goal-directed approach. Inclusive of physiotherapy, occupational therapy, social work and nursing support, transitional rehabilitation is provided for 8–12 weeks following discharge from hospital using direct therapy, education and environmental modification. Located within a metropolitan city, urban clients are supported in their own homes, and rural clients in a homelike environment, using accommodation supplied by the service. However, previous research suggests that discharge planning remains complex, compromised by reduced client participation; difficulties in the identification, education, coordination and funding of local care providers; reduced family involvement; restricted contact with and access to social and community supports; limited specialist support; and challenges with skill acquisition and transfer of learning.3 Despite transitional rehabilitation approaching 20 years of service in Australia, the need remains to develop more effective models of rehabilitation for rural clients. The current study aimed to examine the challenges facing people with SCI returning to rural locations following transitional rehabilitation to inform service delivery.