The prevalence of self-mutilation behavior after spinal cord injury is not known. However, self-biting of fingers after spinal cord injury is a rare phenomenon. We report a case of 51-year-old man self-biting of fingers, resulting in multiple finger amputation following C5 complete spinal cord injury. We believe this to be the first Korean report of multiple finger amputation due to self-biting following spinal cord injury. The mutilative self-biting was related to depression and central pain of upper extremity. After operation for tendon transfer of brachioradialis to extensor carpi radialis brevis, his feeding skills and driving skills on electric-powered wheelchair had been improved, and then, his self-biting of fingers had been diminished. The patient has been temperate in self-biting behavior after administration of gabapentin. In our case, functional improvement of upper extremity by functional surgery and central pain relief by gabapentin provided attenuation of mutilative self-biting behavior. (J Korean Acad Rehab Med 2008; 32: 734-736)