This study investigates anatomical correlates of motor and sensory pathways in stroke patients to enhance understanding of structural and functional changes affecting rehabilitation strategies. Using a crosssectional design, we employed advanced neuroimaging techniques— including MRI, Diffusion Tensor Imaging (DTI), and Functional MRI (fMRI)—to assess differences in primary motor cortex and somatosensory cortex volumes, as well as corticospinal and sensory pathway integrity. We analyzed 30 stroke patients and 30 healthy controls, revealing significant reductions in motor and sensory cortical volumes and decreased pathway integrity in patients. Functional analyses indicated reduced activation in motor and sensory cortices during task performance. Our findings demonstrate significant correlations between changes in motor and sensory pathways, suggesting their interconnected nature. This underscores the need for integrated rehabilitation approaches that address both motor and sensory deficits. The study highlights the impact of structural and functional impairments on stroke rehabilitation, advocating for comprehensive strategies to optimize recovery outcomes.