The role of functional magnetic resonance imaging (FMRI) in patients with stroke is still in evolution. This chapter describes the history of FMRI development, and outlines recent contributions to the understanding of stroke-related brain dysfunction and ends with recommendations for future research in stroke using FMRI. The first report of the mapping of functional changes in regional human brain function using FMRI was done by Belliveau and his group. Imaging sequences are only one important aspect of FMRI. The majority of FMRI work to date has focused on academic studies clarifying brain-behaviour relationships. FMRI studies have significant advantages allowing non-invasive radioisotope-free serial studies of recovering association cortex. Little FMRI work has been done to date to examine recovery following damage to other brain areas or functions. Future integrative research correlating perfusion-diffusion characteristics and site of FMRI activation might shed light on factors predictive of recovery.