Increased attention has focused on the use of brain gangliosides as a treatment for brain injury. This review traces the progression of in vitro and in vivo research which led to studies which have demonstrated that ganglioside treatment can facilitate recovery after CNS damage in animal models (for example, lesions, transections, hypoxia, ischemia). Hypotheses regarding the ability of gangliosides to stimulate neuronal plasticity, modulate trophic factors and reduce injury processes are presented.