Intracortical brain-computer interfaces (iBCI) are poised to revolutionize our ability to restore and preserve neurologic function in the setting of disease and injury. The BrainGate research team has been conducting a multi-site pilot clinical trial (IDE) seeking to determine the safety and feasibility of using an iBCI system to control external devices simply by imagining arm or hand movement in people with paralysis from ALS, cervical spinal cord injury, brainstem stroke, and other neuromuscular diseases. Dr. Hochberg will discuss clinical, engineering, and neuroscientific progress in the ongoing trial, as well as challenges and opportunities for translation to clinical utility.