This issue, ''Contemporary Issues Related to Management of the Upper Limb in Persons with Tetraplegia'', is the third issue of Hand Clinics dedicated entirely to research and clinical interventions for restoration of hand and arm function in persons with tetraplegia. As a direct result of international collaboration, surgical techniques and assistive technologies for improved upper limb function have greatly advanced - giving persons with spinal cord injury monumental capabilities for engagement in work, self-care and leisure. Moreover, an international and more practical understanding of meaningful outcomes - those that are important to people with tetraplegia - has emerged, enabling researchers and clinicians to better meet the expectations of those receiving upper limb care. This issue of Hand Clinics addresses contemporary principles related to the upper limb in tetraplegia - outcomes assessments and measurement issues, surgical technique and rehabilitation of elbow extension transfers and management of the hand of persons with incomplete injuries. In addition, contemporary perspectives internationally will be summarized and presented. Lastly and with much enthusiasm, topics related to shoulder modeling and wheelchair propulsion will be introduced as important areas of consideration when managing the upper limb of persons with spinal cord injury.