To explore the application value of cerebellar diffusion tensor imaging (DTI) in patients after heat stroke (HS). Eleven patients after HS with a score of 3–9 in Glasgow Coma Scale (GCS) and seven age-matched healthy volunteers were selected to undergo MR examinations during the same hot summer. The MR studies including DTI were performed with a 1.5 T scanner. Fractional anisotropy (FA) values of normal-appearing cerebellar white and gray matter were measured and the differences between the two groups were evaluated with Mann–Whitney U test. The FA value of normal-appearing cerebellar white matter in patients after HS was found to be decreased compared to normal control subjects (652.5 ± 86.1 vs 769.5 ± 58.4, p = 0.025). The FA value of normal-appearing cerebellar gray matter in patients after HS was found to be decreased compared to normal control subjects (158.8 ± 27.9 vs 187.5 ± 15.8, p = 0.040). Neural damage of the cerebellum induced by HS may be effectively evaluated by DTI with the decrease of FA value in normal-appearing cerebellum structures.