This review provides a comprehensive overview of biomaterial-based regenerative therapeutic strategies for spinal cord injury (SCI). SCI is a complex neurological disease that often leads to permanent neurological impairment, and current treatments are limited due to the intricate pathological mechanisms and unique post-injury microenvironment. The article systematically discusses various biomaterials, including natural, synthetic, nano, and hybrid materials, and their applications in SCI treatment. It highlights advanced fabrication techniques such as hydrogel, electrospinning, and 3D printing, which are crucial for creating suitable microenvironments to promote tissue regeneration. The review also explores biomaterial-based therapeutic strategies to reduce secondary damage and promote repair, including managing inflammation, reducing oxidative stress, restoring the blood-spinal cord barrier, and reducing glial scarring. Additionally, it discusses methods to enhance neurorestoration, such as stimulating axonal regeneration and forming neuronal relay networks. The article concludes with a discussion of clinical studies and future directions, aiming to provide a reference for further exploration of spinal cord regeneration strategies.This review provides a comprehensive overview of biomaterial-based regenerative therapeutic strategies for spinal cord injury (SCI). SCI is a complex neurological disease that often leads to permanent neurological impairment, and current treatments are limited due to the intricate pathological mechanisms and unique post-injury microenvironment. The article systematically discusses various biomaterials, including natural, synthetic, nano, and hybrid materials, and their applications in SCI treatment. It highlights advanced fabrication techniques such as hydrogel, electrospinning, and 3D printing, which are crucial for creating suitable microenvironments to promote tissue regeneration. The review also explores biomaterial-based therapeutic strategies to reduce secondary damage and promote repair, including managing inflammation, reducing oxidative stress, restoring the blood-spinal cord barrier, and reducing glial scarring. Additionally, it discusses methods to enhance neurorestoration, such as stimulating axonal regeneration and forming neuronal relay networks. The article concludes with a discussion of clinical studies and future directions, aiming to provide a reference for further exploration of spinal cord regeneration strategies.