Objective To investigate the effects of motor imaginary therapy on the balance function recovery in hemiplegic patients after stroke. Methods A total of 32 hospitalized hemiplegic patients after stroke were divided into group A and group B based on the odd or even admission number. From the first to the third week, patients in group A were treated with conventional rehabilitation therapy combined with motor imaginary therapy, and those in group B only received conventional rehabilitation therapy. During the fourth and fifth week (washout period), both patients in group A and B did not accept formal conventional rehabilitation therapy and motor imaginary therapy. In the sixth to eighth week, patients in group B received conventional rehabilitation therapy combined with motor imaginary therapy, and those in group A only received conventional rehabilitation therapy. Berg balance scale scoring was employed to evaluate the balance function of patients before treatment and at the end of the third week, fifth week and eighth week after treatment. Results There was no significant difference in the Berg balance scale score before treatment between group A and group B (P>0.05). Three weeks after treatment, the Berg balance scale scores of group A and B were improved (P<0.01), and Berg balance scale score of group A was superior to that of group B （P<0.05）. Five weeks after treatment, the Berg balance scale scores of group A and B were better than those of two groups 3 weeks after treatment, while there was no significant difference between these two time points (P>0.05), and there was also no significant difference between two groups (P>0.05). Eight weeks after treatment, the Berg balance scale scores of group A and group B were better than those of group A and group B 5 weeks after treatment (P<0.01), and the Berg balance scale score of group B was superior to that of group A (P<0.01). Conclusion On the basis of conventional rehabilitation therapy, motor imaginary therapy can further improve the balance function in hemiplegic patients after stroke and improve the efficacy of rehabilitation training.