Results show that 10 consecutive days of rTMS employed as an add-on intervention to normal physical and drug therapies improves immediate clinical outcome in early stroke patients. Real rTMS led to a higher percentage of independent patients (BI </=75) and a higher percentage of patients having only mild (SSS 50 to 58) disability by the time of the third assessment. Eleven patients with massive infarcts (six real rTMS, five sham rTMS) had the worst improvement and were unaffected by rTMS. Just less than half of the patients in each group had no response to single-pulse TMS over the affected hemisphere at presentation. A larger number of patients in the real rTMS group (from 14 to 21) recovered MEPs by the time of the last assessment, but this was not significantly different from the sham group (from 17 to 18).