Individuals with spinal cord injuries (SCI) experience recurrent and repeated infections, and as such may require frequent antibiotic prescriptions. Little research has been conducted on outpatient antibiotic prescribing in the SCI population, especially in primary care. The purpose of this study is to identify factors impacting outpatient antibiotic prescribing in a primary care SCI cohort. This was a retrospective cohort study using linked electronic medical record (EMR) and health administrative databases from Ontario. A total of 432 individuals with SCI were included in the study. Data was collected from January 2013 to December 2015. Nearly 60% of antibiotics were prescribed by physicians in an individual’s rostered-primary care practice. In primary care, urinary tract infections (UTIs) were the number one indication for prescriptions. More than 40% of these UTI-indicated antibiotic prescriptions were not associated with an appropriate susceptibility test. Individuals, who use catheters, were significantly more likely to receive more antibiotics prescriptions in primary care. Early-career physicians were more likely to prescribed shorter antibiotic durations and order a susceptibility test when prescribing an antibiotic. Male physicians and international medical graduates were more likely to prescribe broad-spectrum antibiotics to treat UTIs. These results provide a better understanding of key issues in outpatient antibiotic prescribing in the SCI population. This information can be used to inform the development of interventions or strategies to improve antibiotic use, including the development of Antimicrobial Stewardship Programs (ASPs).