Treadmill training with body weight support (BWS) was shown to improve locomotion after stroke. We investigated whether BWS affected cortical activation during gait using an optical imaging system. In six patients with subcortical stroke, BWS lowered activation in the sensorimotor cortex (SMC) as assessed by task-related changes of oxygenated hemoglobin levels (P<0.01). The changes of SMC activation correlated with those of cadence (P<0.05). Improvement of asymmetry in SMC activation also correlated with improvement of asymmetric gait (P<0.05). In five age-matched controls, BWS increased overall activation (P<0.05) but did not modify gait parameters and there was no correlation between gait parameters and SMC activation. It is suggested that BWS might improve efficacy of SMC function in patients with stroke.