<p>A major question in cognitive neuroscience is understanding the neural basis of mental imagery, particularly in cases of its absence, known as aphantasia. While research in this field has focused on the role of sensory domains, we propose that the key to understanding imagery lies in the intertwining of sensory processing and autonomic responses. Interoception plays a crucial role in mental imagery by anchoring experiences in first-person physiological signals, providing a self-referential perspective, and grounding the imagery in the body while also enabling its emotional aspects. Moreover, interoception contributes to the sense of agency and volitional control, as well as body schema—hallmarks of voluntary mental imagery. Therefore, imagery should be approached as an integrated phenomenon that combines sensory-specific information with interoceptive signals. At the neural level, this process engages the insula and anterior cingulate cortex (ACC), regions vital for synthesizing information across cognitive, emotional, and physical domains, as well as for supporting self-awareness. From this perspective, aphantasia may reflect a suboptimal functioning of the insula/ACC, which can account for its associations with deficits in autobiographical memory, emotion perception, and conditions such as autism and dyspraxia.</p>