Spinal cord injury (SCI) is a devastating condition that results in loss of motor and sensory function, morbidity, and severe dependence. Neural regeneration, which refers to the regrowth or repair of nerve tissue or cells, holds promise as a therapeutic approach for SCI. This narrative review explores the current state of neural regeneration for SCI treatment, including endogenous neuroprotection, neuroplasticity, neuroremediation, and cell-based therapies. The review is based on a search of literature from the past 20 years, conducted via databases including PubMed and Google Scholar. While many of the studies show promising results, the majority are preclinical, highlighting the need for randomized clinical trials (RCTs) to evaluate the effectiveness of these therapies in humans. Among the different therapeutic approaches, cell-based therapies, particularly the use of neural stem cells, have shown the most promising results in promoting neural regeneration and functional recovery in animal models and human trials. Therefore, neural stem cell transplantation is considered the most useful treatment method for SCI. However, further research is needed to optimize the transplantation procedure, improve cell survival, and enhance functional outcomes in patients with SCI.