The present twin study investigates heritability of motor cortex excitability, measured by the paired pulse transcranial magnetic stimulation technique. Specifically, intracortical facilitation (ICF) and inhibition (ICI) and corticospinal excitability were tested in monozygotic (MZ), dizygotic (DZ), and unrelated pairs (UP). Robust ICF and ICI effects were found, with a higher similarity of MZ than DZ and UP pairs. Heritability estimates (h(2)) were 0.80 for ICI and 0.92 for ICF. However, corticospinal excitability did not show significant differences between MZ and DZ pairs, whereas both significantly differed from UP. Hence, the study provides--for the first time--a clear evidence of heritable individual differences in motor cortex excitability.