This study investigates employment rates and their determinants among individuals with spinal cord injury (SCI) in Romania using data from the Romanian National Spinal Cord Injury Survey (RO-InSCI), part of the International Spinal Cord Injury (InSCI) Community Survey. The cross-sectional study included 215 adults with traumatic or non-traumatic SCI living in the community. Participants were recruited through rehabilitation hospitals and patient organizations. Employment status, demographic characteristics, and injury-related factors were assessed. The observed employment rate was 25.35%, with a 39.45% employment gap compared to the general population. Barriers to employment included health status, disability, inadequate transport, and insufficient access to infrastructure, particularly for those with traumatic SCI. Vocational rehabilitation participation was low (18.7%), despite a strong desire to return to work (82% for traumatic SCI, 61.1% for non-traumatic SCI). Before injury, participants were primarily employed in elementary occupations, with higher rates among those with paraplegia. The findings highlight the need for targeted interventions, inclusive labor market policies, and improved accessibility to vocational rehabilitation to support workforce reintegration and address the specific needs of individuals with SCI in Romania.