Although blindness alters neocortical processing of non-visual tasks, previous studies do not allow clear conclusions about purely perceptual tasks. We used functional magnetic resonance imaging (fMRI) to examine the neural processing underlying tactile microspatial discrimination in the blind. Activity during the tactile microspatial task was contrasted against that during a tactile temporal discrimination task. The spatially selective network included frontoparietal and visual cortical regions. Activation magnitudes in left primary somatosensory cortex and in visual cortical foci predicted acuity thresholds. Effective connectivity was investigated using multivariate Granger causality analyses. Bilateral primary somatosensory cortical foci and a left inferior temporal focus were important sources of connections. Visual cortical regions interacted mainly with one another and with somatosensory cortical regions. Among a set of distributed cortical regions exhibiting greater spatial selectivity in early blind compared to late blind individuals, the age of complete blindness was predicted by activity in a subset of frontoparietal regions and by the weight of a path from the right lateral occipital complex to right occipitopolar cortex. Thus, many aspects of neural processing during tactile microspatial discrimination differ between the blind and sighted, with some of the key differences reflecting visual cortical engagement in the blind.