© 2015 American Congress of Rehabilitation Medicine. Objective To determine the location of cortical activation during a visual illusion walking paradigm, a recently proposed treatment for spinal cord injury (SCI)-related neuropathic pain, in persons with SCI compared with able-bodied controls. Design Pilot experimental functional magnetic resonance imaging (fMRI) trial. Setting Outpatient rehabilitation clinic. Participants Persons with paraplegia (n=3) and able-bodied participants (n=5) were included in this study. Interventions Not applicable. Main Outcome Measure Cortical activation as measured by the blood oxygenation level-dependent method of fMRI. Results During visually illusory walking there was significant activation in the somatosensory cortex among those with SCI. In contrast, able-bodied participants showed little to no significant activation in this area, but they showed activation in the frontal and premotor areas. Conclusions Treatment modalities for SCI-related neuropathic pain that are based on sensory input paradigms (eg, virtual walking, visual illusory walking) may work by targeting the somatosensory cortex, an area that has been previously found to functionally reorganize after SCI.