Abstract: OBJECTIVE: To describe Veterans Affairs (VA) utilization patterns by Veterans with tetraplegia during the first year after cervical spinal cord injury (SCI) and explore differences among subpopulations. A secondary objective of this study was to develop a process map to guide targeted clinician education about upper limb treatment information. DESIGN: Retrospective cohort study using the Veterans Health Administration (VHA) Spinal Cord Injury and Disorders (SCI/D) Registry and the VHA Corporate Data Warehouse. SETTING: Outpatient setting in the VHA. PARTICIPANTS: Veterans (N=884) with traumatic, C5-C8 neurologic level of injury, and American Spinal Injury Association Impairment Scale A-C classification who received care at a regional VA SCI/D Center between October 1, 2012, and September 30, 2019. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: VA health care utilization as defined by ≥1 VA outpatient visit within the first year of SCI using VHA administrative data. We also examined predictors of care interactions using multivariate logistic regression models. RESULTS: In total, 489 Veterans (55%) had ≥1 VA outpatient visit in the first year after SCI whereas 395 Veterans (45%) did not receive outpatient VA care within their first year after SCI. Veterans who used VA health care received a median of 41 outpatient visits in the first year after SCI. Veterans had the highest median number of visits and shortest time interval from SCI to initial visit with therapists (physical, occupational, and recreational) compared to other health care providers. No significant predictors of care were identified with adjusted and unadjusted multivariate logistic regression. CONCLUSIONS: Health care utilization patterns of Veterans with tetraplegia identified physical, occupational, and recreational therapists as the health care providers who had visits early and often with these Veterans. Therapists are uniquely positioned in health care systems to facilitate communication of treatment opportunities to persons with tetraplegia.