Objective To investigate the effects of neural stem cell transplantation on Caspase-3 and c-fos expressions after injury of rat spinal cord. Methods A total of 45 SD rats were randomly divided into 3 groups (n=15), i.e. the sham operation group, spinal cord injury model group (model group), and neural stem cell transplantation group. The cone plate of the sham group was opened without transecting the spinal cord. The cone plate of the model group was opened; the spinal cord was transected; and suture was conducted layer by layer after hemostasis. The cone plate of the neural stem cell transplantation group was opened; the spinal cord was transected; and suture was conducted layer by layer after hemostasis and injection of the neural stem cell suspension. BBB rating was performed for rats 1, 2, 3, and 14 d after surgery. Rats were sacrificed 14 d after surgery and spinal cord tissues were removed. TUNEL labeling was conducted for sections of spinal cord tissue and the neuronal apoptosis was detected. Protein extraction was performed for spinal cord tissues and the expressions of Caspase-3 and c-fos proteins were detected by the Western blotting. Results The scores of BBB rating of the model group and neural stem cell transplantation group were significantly lower than that of the sham operation group (P<0.05), while the improvement of neural function of neural stem cell transplantation group was better than that of the model group (P<0.05). The apoptotic rates of the model group and neural stem cell transplantation group were significantly higher than that of the sham operation group (P<0.05). The apoptotic rate of the neural stem cell transplantation group was significantly lower than that of the model group (P<0.05). The results of Westernblotting showed that the expressions of Caspase-3 and c-fos in the spinal cord tissue of the model group and neural stem cell transplantation group were significantly higher than those of the sham operation group (P<0.05), while the expressions of Caspase-3 and c-fos in the spinal cord tissue of the neural stem cell transplantation group were significantly lower than those of the model group (P<0.05). Conclusion Neural stem cell transplantation can accelerate the recovery; decrease the apoptotic rate; down-regulate the expressions of Caspase-3 and c-fos after the spinal cord of rat is injured; and has the therapeutic effect on spinal cord injury of rats.