Rho is an important signaling target to promote repair following spinal cord injury (SCI). Myelin-derived inhibitory proteins, as well as other classes of known growth inhibitory proteins, block regeneration by signaling activation of Rho. Here, we review the molecular mechanisms of Rho activation after SCI and explain known Rho signaling antagonists. We review the data on use of Rho antagonists to promote axon regeneration, neuroprotection, and functional recovery after SCI. We report on efforts to translate the nonclincal studies on rodents to clinical trials in patients with acute SCI.