Wheelchair users with spinal cord injury (SCI) are at a high risk for falls; however, our understanding of falls and fall prevention in this population remains limited. This thesis, which is comprised of four studies, aimed to advance knowledge in these areas by exploring: (1) the challenges faced by administrators when implementing fall prevention policies and practices in SCI rehabilitation centres, (2) the factors that influence falls/fall risk for wheelchair users with SCI, (3) the psychosocial impact of falls, and the risk of falling on the lives of wheelchair users with SCI, and (4) the perspectives of wheelchair users with SCI on fall circumstances and fall prevention strategies/interventions. Findings from the first qualitative study in this thesis revealed that administrators (n=10) faced challenges with the fall prevention policies/procedures (e.g. not SCI-specific), clinicians (e.g. variable staff adherence), and patients (e.g. balancing risk vs. rehabilitation progress). In study two, photo-elicitation interviews conducted with wheelchair users with SCI (n=12) revealed one overarching theme (i.e. individualized, dynamic, and complex fall risk factors) and four themes: (1) falls and fall risk caused by multiple interacting factors; (2) dynamic nature of fall risk; (3) single factors perceived to reduce falls and fall-related injuries; and, (4) fall prevention experiences and priorities). In study three, photo-elicitation interviews conducted with wheelchair users with SCI (n=12) revealed two themes: (1) varying concern about falling/impact of falls; and (2) fear, falling, and limitations impact daily activities, parenting, work, and leisure/recreation. In study four, thirty-two wheelchair users with SCI participated and more than half of these participants reported a fall over six months. Most fell indoors, in the afternoon, and while transferring or wheeling over uneven ground. Two main themes were identified in study four from a photovoice focus group discussion with wheelchair users with SCI (n=11): circumstances surrounding the falls and preferences for fall prevention strategies/interventions. Current fall prevention approaches fail to meet the complex, dynamic, and individualized fall prevention needs of wheelchair users with SCI, and the psychosocial consequences that could arise from a fall or risk of falling. This thesis advances knowledge to guide fall prevention initiatives for this population.