Neurological damage, and stroke in particular, is the leading cause of long term disability worldwide. There is growing interest in the part that central nervous system reorganisation plays in recovery of function. Techniques such as functional magnetic resonance imaging and transcranial magnetic stimulation permit the non-invasive study of the working human brain, and suggest that functionally relevant adaptive changes occur in the human brain after focal damage. An understanding of how these changes are related to recovery will facilitate the development of novel therapeutic techniques that are based on neurobiological principles and that are designed to minimise impairment in appropriately targeted patients suffering from stroke.