Background/Objectives: Unilateral hand movements alter the excitability of the ipsilateral primary motor cortex (ipsi-M1) and contralateral spinal motoneurons. Although this excitability increases during complex, high muscle-activity movements, few studies have examined the excitability of ipsi-M1 and contralateral spinal motoneurons during complex movements while accounting for muscle activity. This study investigated the excitability of ipsi-M1 and contralateral spinal motoneurons during complex and simple movement tasks with comparable muscle activity between the two tasks. Methods: Nineteen healthy adult volunteers participated in this study. The ball rotation task was set as the complex movement task (BR condition), and the grasping task was set as the simple movement task (grasp condition), with peak muscle activity values comparable between the tasks. Motor-evoked potentials (MEPs) and F-waves were recorded from the abductor pollicis brevis muscle contralateral to the movement during task execution. The excitability parameters of ipsi-M1 and contralateral spinal motoneurons were calculated by dividing the MEP, F-wave persistence, and F/M amplitude values recorded in each condition by the corresponding values recorded at rest. These parameters were compared across the rest, BR, and grasp conditions. Results: All the excitability parameters of ipsi-M1 and contralateral spinal motoneurons increased during both the BR and grasp conditions compared with the rest condition but did not differ significantly between the BR and grasp conditions. Conclusions: The excitability of ipsi-M1 and contralateral spinal motoneurons was strongly influenced by the amount of muscle activity but not by the complexity of the movement.