Objective: Several studies of people with spinal cord injury (SCI) have indicated that high levels of hope are linked with better adjustment, but none has assessed the extent to which hope predicts change in adjustment over time. This study examines the effect of hope assessed within the first months post-SCI onset on changes in several indicators of well-being just prior to release from institutional care and again 13 months post-SCI. Method: Structured interviews were conducted with 67 adults (54 men, 13 women; Mage = 44.7 years, SD = 17.2) with SCI on average 2.6 months (Time 1), 5 months (Time 2; n = 60), and 13 months post-SCI (Time 3; n = 53) using validated instruments to assess dispositional hope, depressive symptoms, subjective well-being, self-esteem, reintegration, and pain. Results: Regression analyses revealed that, of the five indicators of well-being, hope at Time 1 only significantly predicted increases in subjective well-being at Time 2. However, hope predicted increased well-being on 4 of 5 indicators at Time 3. Hope was not significantly associated with changes in self-esteem at either follow-up assessment. Conclusion: People with high levels of hope appear to be better able to adjust to the challenges faced once they leave the rehabilitation center. Psycho-educational interventions that promote agency and pathway thinking may lead to better longer-term adjustment.