Objective: The purpose of this study was to investigate the effects of eccentric contraction training (ECT) and concentric contraction training (CCT) on the muscle thickness (MT), muscle strength (MS) and delayed onset of muscle soreness (DOMS) of the lower extremities in persons with chronic stroke. Design: Randomized controlled trial. Methods: Thirty persons with chronic stroke were randomly assigned to the ECT or the CCT group. The ECT was performed in a specially designed system of eccentric contraction of both legs and, the CCT was performed using a traditional stepper system for concentric contraction of both legs. The training was performed for 30 min/times, 3 times/wk for 6 weeks. Rehabilitation ultrasound imaging was used to measure MT of the vastus medialis/lateralis (VL), and soleus (SOL), a digital muscle tester was used to measure MS, and a visual analog scale was used to assess DOMS. Results: In the ECT group, MT was significantly improved except for SOL resting (p<0.01). In the CCT group, the MT was significantly improved except for VL contraction (p<0.05). The MS was significantly improved in both groups, especially in the ECT group (p<0.01). In the ECT group, muscle soreness was highest in the first week after training but gradually decreased, and in the CCT group, it was highest in the second week of training but gradually decreased (p<0.01). Conclusions: ECT can improve lower limb MT, MS, and DOMS of chronic stroke survivors. Therefore, it is recommended that ECT be used in the rehabilitation of persons with chronic stroke.