Objective. To study the organization of reciprocal constructive activity in patients with ischemic stroke based on hemispheric localization of the lesion and the profile of lateral organization in a segment of leading hand. Material and methods. The study included 57 post-stroke patients. An experimental method and a set of neuropsychological tests were used. Results and сonclusions. There was an overall decline in the parameters of constructive activity (accuracy and rate) in patients with ischemic stroke, regardless of localization of the lesion and the profile of lateral brain organization in the segment of leading hand. Constructive activities of left-handed patients with right-hemisphere stroke and right-handed patients with left-hemisphere lesions are regulated by reciprocal and dynamic organization of praxis functions. In right-handed patients with right hemisphere ischemic stroke and left-handed patients with left-hemisphere lesions, constructive activities are regulated by the kinetic-kinesthetic organization of the motor act, dynamic organization of the motor act that characterizes the reciprocal organization.