Functional MRI was performed in two acute stroke patients and six control subjects performing unilateral and bilateral repetitive gripping tasks. Patients were tested at three time points during recovery. Initially, bilateral movement enhanced activation in the primary motor cortex (M1) of the affected hemisphere compared with unilateral paretic hand movement. With recovery, activation of M1 in the affected hemisphere did not differ between unilateral paretic hand and bilateral movement. These preliminary data may have potential implications for acute stroke motor rehabilitation.