Introduction Empathizing is the ability to identify the mental states of others, for predicting their behavior and responding with appropriate emotion. Two routes to empathy are discussed: One relatively automatically process, with fast emotional responding and late appraisal. A second way is less automatic with early cognitive appraisal. Brain areas with structural changes related to empathy comprising regions from the mirror neuron system (MNS) and the default mode network (DMN). Positive and negative associations between empathizing and regional gray matter (GM) volume were found in healthy controls in the left inferior frontal gyrus (IFG), insula and superior temporal sulcus. Facing these divergent correlative effects, we compared GM volume of healthy females with low and high empathic behavior. Methods From a sample of 269 female healthy students completing the Empathy Quotient (EQ), 20 individuals with EQ > 45 (mean age 22.8) were compared with 20 age-matched individuals with an EQ p p Results In the region-of-interest-based analysis, none of the regions was showing a significant group difference. The exploratory voxelwise analysis yielded clusters of reduced GM volume in the LE group in right and more prominent in left frontal, bilateral occipital and temporal regions, comprising the left middle and superior frontal gyrus, the right middle and inferior temporal gyrus, the bilateral IFG, fusiform gyrus, lingual gyrus and cerebellum. For the HE group, the most prominent cluster of reduced GM volume comprising the right parahippocampus, temporal inferior gyrus and cerebellum. Another cluster was consisting of voxels from the left insula, superior temporal gyrus, rolandic operculum and superior part of temporal pole and clusters were also found in the right caudate and less pronounced in the left middle occipital lobe and in the right superior medial frontal gyrus. Discussion We did not find any group effects in the region-of-interest-based analysis. Most likely are variations in normal empathic behavior in healthy individuals associated with localized sub-regional brain structure differences. Indeed, the exploratory voxel-wise approach revealed that both groups show different clusters of altered GM volume. The HE group showed increased GM volume in frontal regions, comprising MNS and in lateral occipital and temporal regions associated with social recognition. Regions with increased GM volume were found in regions related to reconstructive empathy (left insula and right parahippocampal gyrus) in the LE group.