The aim of this study was to investigate the physiological responses to maximal and submaximal arm-cranking exercise in 21 individuals with tetraplegia (TP) and to evaluate the effect of a 3 and 6-month training period (mean frequency of 1.5 h.week-1, mean intensity at 35% of the training time above 60% of the heart rate reserve) on these physiological responses. The TP were divided into 8 trained subjects (T), 7 untrained subjects (U) who started their training at the beginning of the study, and 6 sedentary subjects (S). All the subjects were tested at the beginning of training and after 6 months, whereas T and U were also tested in between, at 3 months. During maximal exercise, peak power output and peak oxygen uptake per kilogram bodymass were significantly higher in T (49.9 W and 14.2 ml.min-1.kg-1 respectively) compared to U (20.7 W and 8.8 ml.min-1.kg-1 respectively) and S (15.9 W and 7.4 ml.min-1.kg-1 respectively), whereas all other peak responses showed tendencies to be higher in T. This is most likely to have been the result of participation in sport and the effect of it on performance capacity in T, although differences in completeness of the lesion may have influenced the results. No significant differences were found for submaximal and maximal responses after 3 or 6 months of training in either T and U or in S. This may have been due on the one hand to the vulnerability of the subjects to diseases and injuries and on the other hand to the low frequency of training. On an individual basis, however, remarkable improvement was observed during the training period, especially for individuals in the U group. These results would suggest that a 3 or 6-month training period has no measurable positive effect on the fitness level of TP.