To observe how the pyramidal tract changes after rehabilitation of stroke patients with hemiplegia. This article reports two patients with basal ganglia infarction, who underwent brain magnetic resonance imaging (MRI) and recorded the motor function of the hemiplegic limb. Their initial assessment of motor function showed similar degrees of injury, but the final assessment after a 3-month interval showed significant differences in rehabilitation outcomes. We used diffusion tensor tractography technology to depict the corticospinal tract and observed that two patients showed different degrees of damage on the initial scan. For one of the patients, there was a significant increase in white matter fibers after rehabilitation, corresponding to an improvement in her rehabilitation score. The fiber bundle changes in the other patient were not very obvious, but the distribution of different length of fibers were changed.