Objective: To assess the necessity of extra rounds of urine culture when symptom of urinary tract infection (UTI) is developed from asymptomatic bacteriuria in spinal cord injury patients. Method: A total of 226 patients who took a urine culture at least twice during their stay and did not show symptoms of UTI at the admission were chosen. We then divided them into two groups: the one with patients who showed symptoms of UTI, and the other with ones who did not. Follow-up urine culture was performed when patients had symptoms of UTI or after one month from admission. Results: 1) Of the 226 patients, 60 patients showed symptoms of UTI, while 166 patients did not. 2) From the UTI group, there were 38 (63.3%) patients whose organism from their urine culture changed. From the non-UTI group, 79 (47.6%) patients saw their organism from their urine culture changed. 3) From the UTI group, there were 31 (56.4%) patients whose organism was more resistant to the antibiotics. From the non-UTI group, there were 80 (68.4%) patients whose organism was more resistant to the antibiotics. Conclusion: If UTI occurs in spinal cord injury patients, new organism might be detected in urine culture. Therefore, we should choose the proper antibiotics based on results of follow-up urine culture performed when the patients had symptoms of UTI. (J Korean Acad Rehab Med 2008; 32: 38-44)