Stuttering, a common communication disorder, affects individuals of all ages but is most prevalent in early childhood. Recent studies have identified early brain alterations linked to stuttering, with spontaneous recovery in children associated with increased inter-area connectivity. Therapy-driven improvement in adults is linked to functional reorganization within and beyond the speech network. However, the etiology of stuttering remains enigmatic. This article highlights critical questions and points to neuroimaging findings that could inspire future research to uncover how genetics, interacting neural hierarchies, social context, and reward circuitry contribute to the many facets of stuttering. Key points include: 1. **Genetic Contributions**: Twin studies and family history suggest genetic factors play a role, with a higher probability of stuttering in monozygotic twins and a male-to-female ratio of 1:4 in adults. 2. **Neural Markers**: Children and adults who stutter show atypical brain structure and functional patterns, particularly in cortical areas of the speech motor planning and control networks. 3. **Spontaneous Recovery**: Spontaneous recovery in children is linked to age-related growth in white matter structures, which enable fast and accurate sequential speech movements. 4. **Therapy-Induced Improvements**: Therapy can lead to functional reorganization within and beyond the speech network, including increased activity in brain areas associated with fluent speech and normalization of brain activity differences. 5. **Unsolved Mysteries**: Questions remain about the critical period of speech acquisition, the role of social context, and sex differences in stuttering. The article emphasizes the need for further research to understand the complex neurobiological underpinnings of stuttering and to develop effective treatments.Stuttering, a common communication disorder, affects individuals of all ages but is most prevalent in early childhood. Recent studies have identified early brain alterations linked to stuttering, with spontaneous recovery in children associated with increased inter-area connectivity. Therapy-driven improvement in adults is linked to functional reorganization within and beyond the speech network. However, the etiology of stuttering remains enigmatic. This article highlights critical questions and points to neuroimaging findings that could inspire future research to uncover how genetics, interacting neural hierarchies, social context, and reward circuitry contribute to the many facets of stuttering. Key points include: 1. **Genetic Contributions**: Twin studies and family history suggest genetic factors play a role, with a higher probability of stuttering in monozygotic twins and a male-to-female ratio of 1:4 in adults. 2. **Neural Markers**: Children and adults who stutter show atypical brain structure and functional patterns, particularly in cortical areas of the speech motor planning and control networks. 3. **Spontaneous Recovery**: Spontaneous recovery in children is linked to age-related growth in white matter structures, which enable fast and accurate sequential speech movements. 4. **Therapy-Induced Improvements**: Therapy can lead to functional reorganization within and beyond the speech network, including increased activity in brain areas associated with fluent speech and normalization of brain activity differences. 5. **Unsolved Mysteries**: Questions remain about the critical period of speech acquisition, the role of social context, and sex differences in stuttering. The article emphasizes the need for further research to understand the complex neurobiological underpinnings of stuttering and to develop effective treatments.