Patients with cervical spinal cord injury face several clinical problems. One of the problems is voice impairment secondary to poor respiratory support. Their syllables per breath, vocal intensity and vocal quality are impaired. This paper studied the impact of the impairment on the individuals’ communication ability and participation in the community. Study patients included those who had sustained a spinal cord injury above C8 level and were living in the community. They were evaluated with a series of voice and speech assessments, Voice Handicap Index, the Australian Therapy Outcome Measures Voice Scale, Four Voice Perception questions and the General Short Form of the Communication Participation Item Bank. All participants were found to have decreased vocal intensity and phonatory duration. About one-fourth of the participants had impaired pitch control, breath support, rate of speech and length of phrase. Although speech and voice mild impairment exists in all patients following spinal cord injury, it has minimal impact on daily life. All participants in the study reported varying degrees of negative impact on communication in their daily life. A few reported significant impairment with difficulty communicating with family, friends and at work. The authors suggest that it is important to monitor the communication functionality in individuals with spinal cord injury so as to identify those who require additional intervention and support to live in the community and communicate effectively.