This review aims to emphasize the diagnostic value of functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) tractography in detecting and diagnosing central post-stroke pain (CPSP). CPSP is a debilitating form of chronic neuropathic pain that develops in patients with a history of stroke. CPSP has a wide range of onset and non-specific clinical presentations, making it difficult to detect. Until now, CPSP has been considered a diagnosis of exclusion, often leading to delays in the initiation of the appropriate treatment plan. fMRI and DTI tractography are valuable tools for assessing cerebral metabolic activity and the structural characteristics of the spinothalamic tracts, respectively. By combining these sets of information, physicians can detect CPSP early and implement more effective treatment strategies. Diagnosing CPSP has been challenging for physicians due to its complex nature. However, fMRI and DTI have the potential in enabling earlier detection of CPSP, giving physicians more time to initiate treatment. This review highlights the capacities of fMRI and DTI in identifying alterations in the spinothalamic pathways associated with CPSP.