Aging is a challenge for everyone but particularly for people with significant disabilities such as a spinal cord injury (SCI). There have been four distinct groups among those with a SCI each of which has unique experiences and needs. Based on the heterogeneity in age at injury and age of the SCI (also called as years post injury or duration of injury), individuals with SCI can be broadly classified into four categories: (i) younger with acute injury (<50 years with duration of injury <5 years); (ii) younger with chronic injury (<50 years with duration of injury >20 years); (iii) older with acute injury (>50 years with duration of injury <5 years); and (iv) older with chronic injury (>50 years with duration of injury >20 years). Literature suggests that these four sub-groups are significantly different in the domains of their functioning, rehabilitation needs, and functional outcomes that they can achieve. Specifically, those who are old and injured at an old age (group 3) have higher mortality and morbidity rates; are more dependent on others for basic activities for daily living; and have poorer psychosocial outcomes. Therefore, the purpose of this study was to synthesize the available evidence on effectiveness of rehabilitation interventions, specifically for improving psychosocial outcomes for older adults who sustained SCI at an older age. Drawing from the systematically conducted review of literature, preliminary findings of this study suggest that the existing literature does not substantially recognize the difference between the needs and experiences of those who are younger or ageing with SCI (group 1, 2, and 4) from those who are getting SCI in the old age (group 3). Consequently, compared to the vast amount of research on the needs and rehabilitation interventions for younger adults with SCI, the research on interventions specifically designed and tested for older adults with SCI has been limited. Overall, the SCI rehabilitation research till date does not address the need to adapt or modify rehabilitation interventions to improve the psychosocial outcomes for older adults who suffered SCI at an old age. These findings pose significant implications for both gerontology and rehabilitation research, policy, and practice. Therefore, empirical research is warranted to identify the interventions that work for this population and the contexts in which they (do or do not) work. Fulfillment of this gap of knowledge will help (a) rehabilitation professionals to adopt appropriate rehabilitation interventions that can address the needs and concerns of older adults with SCI who suffer SCI at an old age in a holistic and unique way; (b) policy makers to take rational decisions related to funding rehabilitation care for these individuals; and (c) global organizations (such as World Health Organization) in the development of standard practices involving appropriate rehabilitation interventions for this group of people. These efforts will in-turn help the older individuals with SCI to cope with the experience of a new and often a life changing injury successfully, and return to the community to live a fulfilling life that they desire and deserve.