Sympathetic and parasympathetic ganglia, which contain the visceral lower motor neurons that innervate smooth muscles, cardiac muscle, and glands, are controlled by preganglionic neurons in the spinal cord and brainstem. The sympathetic preganglionic neurons that govern ganglion cells in the sympathetic division of the visceral motor system arise from neurons in the thoracic and upper lumbar segments of the spinal cord; parasympathetic preganglionic neurons, in contrast, are located in the brainstem. Preganglionic neurons in the sacral spinal cord have long been considered parasympathetic, but recent evidence shows that they share many features with preganglionic neurons in the thoraco-lumbar cord. Sympathetic ganglion cells are distributed in the sympathetic chain (paravertebral) and prevertebral ganglia, whereas the parasympathetic motor neurons are more widely distributed in ganglia that lie in or near the organs they control. Most visceral structures receive inputs from both the sympathetic and parasympathetic systems, which act in a generally antagonistic fashion. The diversity of autonomic functions is achieved primarily by different types of receptors for the two primary classes of postganglionic autonomic neurotransmitters, norepinephrine in the case of the sympathetic division and acetylcholine in the parasympathetic division. The visceral motor system is regulated by sensory feedback provided by dorsal root and cranial nerve sensory ganglion cells that make local reflex connections in the spinal cord or brainstem and project to the nucleus of the solitary tract in the brainstem. The visceral motor system is also regulated by descending pathways from the hypothalamus and brainstem reticular formation, the major control centers of homeostasis more generally. The importance of the visceral motor control of organs such as the heart, bladder, and reproductive organs—and the many pharmacological means of modulating autonomic function—have made visceral motor control a central theme in clinical medicine.