This photographer used an overhead technique to give a realistic feel to the photo. This photo looks like it was taken from a hotel ceiling and that the people are real and not toys. I like the illusion that this photo conveys. It accurately captures the hustle and bustle of busy buildings. The strong lighting also adds to the photo because the reflection of it on the wall really opens the space up.
They are real. It is called toy or miniaturized photography because the technique makes people look like toys.