Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the principles adopted in digital scenarios. This study is a randomized controlled trial conducted on 40 patients with stroke, comparing a protocol of art therapy administered in virtual reality, which exploits the so-called Michelangelo effect, to conventional therapy. After 12 sessions, patients in the virtual art therapy group showed a significantly greater improvement in independence in activities of daily living, as assessed by the Barthel Index (interaction of time and group: p<0.01). Significant differences were also found in terms of upper limb muscle strength (Manual Muscle Test, p<0.01) and reduction in spasticity (Ashworth scale, p<0.01) in favor of the experimental group. In the virtual art therapy group, the effectiveness of the intervention was significantly correlated with patient participation (Pittsburgh Rehabilitation Participation Scale: R=0.45), patient satisfaction (R=0.50), and the perceived utility of the intervention by the therapist (R=0.47). These findings support the efficacy of virtual art therapy leveraging the Michelangelo effect. Further studies should also focus on cognitive domains that could benefit from this type of approach.