Traumatic spinal cord injury (SCI) can lead to permanent neurological impairment, underscoring the urgency of regular therapeutic intervention and monitoring. In this study, we propose a new strategy for monitoring spinal cord injury through serum based on high-resolution THz attenuated total reflection frequency domain spectroscopy (THz-ATR-FDS). We demonstrated serum spectral differences at different time points after experimental SCI in rats. We also studied the relationship between serum lipid concentration and the time of SCI, which revealed the potential of lipid molecules as biomarkers of SCI. In addition, based on the principal component analysis (PCA) and least squares regression (LSR) models, the quantitative relationship between the refractive index spectrum and lipid concentration in serum was automatically analyzed. This work highlights terahertz spectroscopy as a promising tool for label-free, periodic, and efficient monitoring of SCI.