We report the clinical usefulness of elucidating the state of the corticospinal tract (CST) by the use of diffusion tensor image tractography (DTT) in hemiparetic stroke patients. DTT was performed using 1.5 T magnetic resonance imaging. DTT demonstrated that the CST of the affected hemisphere was preserved in the medial portion of the hematoma in patient 1, but was interrupted by a hematoma in patient 2. DTT seems to be useful for elucidating the status of the CST in hemiparetic stroke patients. (J Korean Acad Rehab Med 2008; 32: 222-225)