A positive pyramidal fasciculus sign indicates an upper motor neuron disorder, which clinically indicates a positive sign and is commonly seen in disorders related to the brain and spinal cord. A positive pyramidal fasciculus sign is a common sign on neurologic examination that has clinical significance for upper motor neuron disorders. The main and most commonly used pyramidal sign is Babinski’s sign, and others include multiple ischial signs, such as Chaddock’s sign, Oppenheim’s sign, and Gordon’s sign, where a positive reaction to this pathology is characterized by dorsiflexion of the bunion and fanning out of the remaining toes. Positive cone-bundle signs are commonly associated with brain and spinal cord disorders, such as cerebrovascular disease, brain inflammation, demyelinating disease, spinal vascular disease, myelitis, and demyelinating lesions of the spinal cord. If the cone beam sign is positive, it is recommended to consult a doctor as soon as possible to identify the cause of the disease and give appropriate treatment under the guidance of a specialized physician.