Spinal cord stimulation (SCS) is an advanced therapy and method of pain management for certain types of chronic pain. SCS has thus far been shown to be more effective for neuropathic forms of pain than for nociceptive forms of pain. The history of electrical stimulation for pain relief is reviewed as well as the basic anatomy of the spinal cord. Although its exact mechanisms are still unknown, SCS involves both neurophysiological mechanisms and pharmacological mechanisms to achieve paresthesia. The implantable pulse generator (IPG) and external radio frequency (RF) spinal cord stimulators, their parameters, and implantation procedures are described. Future success of SCS will depend on improving the model for SCS's mechanisms, improving the patient selection criteria, and optimizing the lead configuration for improved pain relief.