Animal and human research over the past decades have increasingly detailed the brain's capacity for reorganization of neural network architecture to adapt to environmental needs. In this article, the authors outline the range of reorganization of human representational cortex, encompassing 1) reconstruction in concurrence with enhanced behaviorally relevant afferent activity (examples include skilled musicians and blind Braille readers); 2) injury-related response dynamics as, for instance, driven by loss of input (examples include stroke, amputation, or in blind individuals); and 3) maladaptive reorganization pushed by the interaction between neuroplastic processes and aberrant environmental requirements (examples include synchronicity of input nurturing focal hand dystonia). These types of neuroplasticity have consequences for both understanding pathological dynamics and therapeutic options. This will be illustrated in examples of motor and language rehabilitation after stroke, the treatment of focal hand dystonia, and concomitants of injury-related reorganization such as phantom limb pain. NEUROSCIENTIST 10 (2) Research from our own laboratory, which is described in the following review, was supported by the Deutsche Forschungsgemeinschaft and the Volkswagenstiftung. Many colleagues have contributed through collaboration or with their discussions and ideas to this work. We are particularly grateful to Christoph Braun, Herta Flor, Stefan Knecht, Wolfgang Miltner, Christo Pantev, Friedemann Pulvermüller, Christina Robert, Edward Taub, and Christian Wienbruch.Address correspondence to: Dr. Thomas Elbert, University of Konstanz, Fach-D25, D-78457 Konstanz, Germany (e-mail: thomas.elbert@uni-konstanz.de).REVIEW ■ *For each sensory modality, the cortical representations relate in an orderly way to the spatial arrangement of receptors in the periphery forming organotopic maps. The most prominent example of this organizational principle is the homuncular representation in the somatosensory system. Similarly, an orderly arrangement of the representation of frequencies in Heschl's gyrus reflects the tonotopy already present in the cochlea, and the visual cortex builds its increasingly higher levels of functional organization on a retinotopic arrangement.