Stroke is a leading cause of upper extremity deficits worldwide. Persistent upper extremity dysfunction affects many post stroke patients and is strongly associated with decreased activities of daily living and poor quality of life. There is accumulating evidence of a cross-over effect with training of one limb that slightly increase strength and coordination in contralateral untrained limb through neurological adaptations. One of rehabilitation that is beneficial for stroke patient is motor imagery, a mental rehearsal of a movement that does not include physical movement has been shown to enhance upper limb function. Evidence demonstrate that MI not only activates motor cortical and subcortical regions but also induces plastic change in motor networks and modulates synaptic activity at spinal level.