The anatomical basis of the pyramidal tract is reviewed with respect to its proposed role in the conduction of the motor evoked potential. The fiber diameter profiles are discussed in relation to the measured conduction velocities of the corticospinal tract in humans. Stimulus parameters utilized to obtain the motor evoked potential are reviewed in relation to the laterality of response, response threshold, and properties of spatial and temporal summation. A discussion of the major descending tracts involved with walking as opposed to fine distal use of the digits is undertaken in the context of the possible prognostic capabilities of the motor evoked potential.