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Objective: This study aimed to investigate the differential effects of bilateral and unilateral mirror therapy (MT) on motor cortical activations in stroke patients by magnetoencephalography (MEG)., Methods: Sixteen stroke patients and 16 right-handed healthy volunteers were recruited. All participants were required to perform 4 conditions: resting, no mirror with bilateral hand movements (Bilateral-No mirror), mirror with bilateral hand movements (Bilateral-Mirror) and mirror with unilateral hand movements (Unilateral-Mirror). Beta oscillatory activities in the primary motor cortex (M1) were collected during each condition using MEG. The percentage change of beta oscillatory activity was calculated for each condition to correct the baseline differences., Results: In the stroke group, the percentage change of M1 beta oscillatory activity significantly decreased more in the Bilateral-Mirror condition than in the Bilateral-No mirror and Unilateral-Mirror conditions. In the healthy group, no significant differences in the percentage change of beta oscillatory activity were found among the 3 conditions. Further, a significant difference in the percentage change of beta oscillatory activity only in the Bilateral-Mirror condition was found between the 2 groups., Conclusions: This study provides new information on the differential cortical activations modulated by bilateral and unilateral MT., Significance: Bilateral MT led to greater M1 neural activities than unilateral MT and bilateral movements without a mirror in stroke patients., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)