Objective To investigate the effect of different treatments on corticospinal tracts(CST) after cerebral infarction with diffusion tensor imaging(DTI). Methods A total of thirty patients with chronic cerebral infarction who suffered from one to six months were collected and divided into group A and group B randomly, and they were treated with conventional drug therapy and non-drug therapy (mainly mobilization treatment and occupational therapy) respectively. Routine MRI and DTI examination were conducted and fractional anisotropy (FA) of infarcts and ipsilateral cerebral peduncles were measured before and after treatment. Calculating the change rates of FA values before and after treatments in respect to different treatments and different parts. Pearson correlation were analyzed between patients' stores of stroke rehabilitation assessment of movement (STREAM) and change rates of FA values. Results Both group A (P=0.041 and P=0.03) and group B (P=0.015 and P=0.024) could found a significant decrease of FA values after treatment in infarcts and ipsilateral cerebral peduncles. Among the groups, the FA reduction rates in cerebral peduncles of group A and B was lower than that in infarcts(P=0.001 and P=0.017). Between groups, there was no significant difference in FA reduction rate between the two groups in infarcts.(P=0.072). But the reduction rate of group A was lower than group B in cerebral peduncles (P=0.006). There was a significant negative correlation between FA reduction rates of cerebral peduncles and STREAM score in group A and group B. Conclusion Rehabilitation therapy can effectively reduce the degeneration and damage of CST after cerebral infarction. Besides, drug is more conducive to the reconstruction of CST.