Aims: To detemined whether autonomic dysreflexia (AD) occurs in patients with spinal cord injury (SCI) with neurological level below thoracic (T) 6 during urodynamic examination. Design: Cross sectional survey. Subject and methods: The study was carried out in 56 patients with SCI below Th6 who were submitted to our center for a urodynamic examination from January to June 2020. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured and recorded at the beginning and every 100 ml infused during the filling phase of the urodynamic study. AD was defined as a rise in systolic blood pressure above 20mm Hg. Results: Autonomic dysreflexia developed only in two of the 56 patients included into the study. One of the patient BP increased from 90/60 mmHg to 115/75 mmHg together with development of the AD symptoms, he was a 31 year old male with a neurological level at T8. The other BP increased from 105/71 mmHg to 131/86 mmHg without the development of the AD symptoms, he was a 56 year old male with a neurological level at T7. A significant difference was found between the mean SBP and the mean DBP values at the beginning and end of the filling phase in them. Conclusions: It is rare, but possible that AD occurred in patients with lesions below T6, especially for those colose to the T6 level. We recommend continuous cardiovascular monitoring during urodynamic investment in the patients closer to T6 level for the detection of symptomatic and asymptomatic AD.