Background and Purpose: Gait coordination often is compromised after stroke. The purpose of this study was to evaluate the efficacy of acoustically paced treadmill walking as a method for improving gait coordination in people after stroke. Participants: Ten people after stroke volunteered for the study and comprised the experimental group. Nine elderly people who were healthy served as a control group. Methods: Gait cycle parameters, interlimb coordination, and auditory-motor coordination were examined while participants walked on a treadmill with and without acoustic pacing. Results: Stride frequency was adjusted to different acoustic pacing frequencies in all participants. In people after strike, gait symmetry improved with acoustic pacing. They predominantly coordinated movements of the nonparetic limb to ipsilateral tones. Discussion and Conclusion: The results suggest that acoustically paced treadmill walking provides an effective means for immediately modifying stride frequency and improving gait coordination in people after stroke and, therefore, may be usefully applied in physical therapist practice. Future research directions for developing guidelines for using acoustically paced treadmill walking in physical therapist practice are discussed. © 2007 American Physical Therapy Association.