In here we aimed at characterizing the impact of the HIFU thalamotomy over the cerebello-thalamic pathway. We used probabilistic tractography to map the subject-specific anatomy of this pathway, we defined a set of regions along a group average pathway, and we extracted DTI based average values in these regions. We found local and distant alterations along the pathway 3-months post-treatment. These changes were strongly correlated with the clinical improvement of the patients. These findings serve to strengthen DWI, as a tool to aid in the targeting of HIFU in the treatment of essential tremor.