Study design Experimental study. Objective Individuals with spinal cord injuries (SCI) may present with impaired sympathetic control over thermoregulatory responses to environmental and exercise stressors, which can impact regional core temperature (T-core) measurement. The purpose of this study was to investigate whether regional differences in T-core responses exist during exercise in individuals with SCI. Setting Rehabilitation centre in Wakayama, Japan. Methods We recruited 12 men with motor-complete SCI (7 tetraplegia, 5 paraplegia) and 5 able-bodied controls to complete a 30-min bout of arm-cycling exercise at 50% VO2 peak reserve. T-core was estimated using telemetric pills (intestinal temperature; T-int) and esophageal probes (T-eso). Heat storage was calculated from baseline to 15 and 30 min of exercise. Results At 15 min of exercise, elevations in T-eso (Delta 0.39 +/- 0.22 degrees C; P < 0.05), but not T-int (Delta 0.04 +/- 0.18 degrees C; P = 0.09), were observed in able-bodied men. At 30 min of exercise, men with paraplegia and able-bodied men both exhibited increases in T-eso (paraplegia: Delta 0.56 +/- 0.30 degrees C, P < 0.05; able-bodied men: Delta 0.60 +/- 0.31 degrees C, P < 0.05) and T-int (paraplegia: Delta 0.38 +/- 0.33 degrees C, P < 0.05; able-bodied men: Delta 0.30 +/- 0.30 degrees C, P < 0.05). T-eso began rising 7.2 min earlier than T-int (pooled, P < 0.01). Heat storage estimated by T-eso was greater than heat storage estimated by T-int at 15 min (P = 0.02) and 30 min (P = 0.03) in men with paraplegia. No elevations in T-eso, T-int, or heat storage were observed in men with tetraplegia. Conclusions While not interchangeable, both T-eso and T-int are sensitive to elevations in T-core during arm-cycling exercise in men with paraplegia, although T-eso may have superior sensitivity to capture temperature information earlier during exercise.