Objective: To describe how persons with spinal cord injury perceived their participation in life situations and to determine the relationship between their participation and perceived problems therewith. The purpose was also to evaluate the influence of age, sex, level of injury, time since injury, marital status and access to social support on perceived problems with participation. Design: Cross-sectional. Subjects: One hundred sixty-one persons with spinal cord injury. Methods: A postal questionnaire including socio-demographic characteristics and a Swedish version of the Impact on Participation and Autonomy questionnaire. Results: A majority of the respondents perceived their participation as sufficient in most activities addressed. Still, a majority of the respondents perceived one or more severe problems with their participation. Access to social support was the most influencing variable in predicting perceived severe problems with participation as compared with certain personal and health-related factors. Conclusion: The results suggest that it is important to consider access to social support along with other factors in the person-environment interaction and their influence on severe problems with participation in enhancing clients' participation in rehabilitation.