Mirror neurons discharge during the execution of ecological goal-directed manual and oral actions, as well as during the observation of the same actions done by other individuals. These neurons were first identified in the ventral premotor cortex (PMv; area F5) and later on in the inferior parietal lobule (areas PF and PFG) of monkey brain, constituting a “mirror neuron” system. Several pieces of experimental data suggest that a mirror neuron system devoted to hand, mouth, and foot actions might also be present in humans. In the present paper, we review the experimental evidence on the role of the mirror neuron system in action understanding and imitation, both in hand motor function and speech. Based on the features of the mirror neuron system and its role in action understanding and imitation, we discuss the use of action observation and imitation as an approach for systematic training in the rehabilitation of patients with motor impairment of the upper limb and aphasia following stroke. We present the results of some preliminary studies to test this concept, and a discussion of network models as a measure of neurobiological change. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 54:293-310, 2012.