Sympathetic preganglionic neurons receive direct, monosynaptic input from a series of well defined nuclei in the brainstem and the hypothalamus. These premotor cell groups coordinate sympathetic control with ongoing endocrine and behavioral response. However, it is not known precisely which populations of sympathetic premotor neurons are activated during specific responses, such as fever after intravenous lipopolysaccharide (LPS). We used the activation of c-fos protein expression in spinally projecting neurons during intravenous LPS fever as a model for examining the functional organization of this system. Intravenous LPS (5 μg/kg) induced Fos-like immunoreactivity in sympathetic preganglionic neurons in the spinal cord as well as several sympathetic premotor nuclei, including the paraventricular nucleus of the hypothalamus, rostral and caudal levels of the ventrolateral medulla, and the nucleus of the solitary tract. After injecting Fluorogold into the intermediolateral column at the T1–L1 spinal levels, neurons that were both Fos immunoreactive and retrogradely labeled were found only in the dorsal parvicellular division of the paraventricular nucleus in the hypothalamus, the rostral ventrolateral medulla (C1 adrenergic cell group), and the A5 noradrenergic cell group in the brainstem. The same pattern of double-labeling was seen from injections at each spinal cord level. These findings suggest that only a limited pool of hypothalamo-sympathetic neurons contribute to the fever response and that they may do so by contacting specific populations of preganglionic neurons that are distributed across a wide range of spinal levels. The anatomical specificity of the paraventriculo-spinal projection is thus functional rather than topographic.