Spinal cord injury is a serious injury of the central nervous system, and there is currently a lack of effective treatment. In recent years, it has been found that endogenous neural stem cells (ENSCs) in ependymal region of spinal cord have the potential to promote the repair of spinal cord injury. Spinal cord injury and microenvironment changes can promote the activation, proliferation, and differentiation of ENSCs in the ependymal region of the spinal cord, which helps to repair damaged neural structures. Although ENSCs play a positive role in the repair of spinal cord injury, the mechanism remains inconclusive. This article reviews the potential mechanism of spinal cord ependymal region ENSCs in the repair of spinal cord injury, providing more data to know the function of ENSCs in ependymal region of spinal cord from both basic and clinical perspective.