Background Despite advances in therapy, inflammatory demyelinating diseases of the central nervous system, such as multiple sclerosis, remain important causes of morbidity among young adults. Translation of remyelinating paradigms from current murine models is encumbered by the small size and low white matter content of the brains, limiting the spatial resolution of diagnostic imaging. Large animal models might be more suited for this purpose but pose significant technological, ethical and logistical challenges. Methods We induced reversible and targeted cerebral demyelinating lesions by controlled injection of lysophosphatidylcholine in the minipig brain. One strength of the approach is the serial induction, allowing parallel imaging of successive stages of de-/remyelination. Findings We demonstrate controlled, clinically unapparent, reversible and multimodally trackable brain white matter demyelination in a large animal model. Lesions were amenable to follow-up using the same clinical imaging modalities (3T magnetic resonance imaging, 11C-PIB positron emission tomography) and standard histopathology protocols as for human diagnostics, as well as electron microscopy to compare against biopsy data from two patients with cerebral demyelination. Interpretation By employing human diagnostic tools and validating the model against data from related human diseases, our platform overcomes one important translational barrier of current animal brain demyelination models while having the potential for developing diagnostic procedures and imaging biomarkers. Remyelination and axon preservation dynamics diverge from classical rodent models.