Abstract A 69-year-old right-handed man developed alexia with agraphia after resection of a brain tumor in the left parietal lobe. After the operation, neurological examination revealed right lower quadrantanopia, mild paresis and sensory disturbance on the right side. He showed marked alexia with agraphia, very mild aphasia, acalculia, and constructional disability. In reading tasks, he was able to read kanji word and kana words but not a single kana character or nonword. After he traced a single kana character or kana nonword, he was able to read it. In writing tasks, he could write kana but not kanji characters, except simple kanji characters that involved less than 4 strokes. These findings indicated that kinesthetic traces may enable such patients to read and write. We propose that processes of reading and writing may include kinesthetic route in addition to the meaning, phonological, and orthographical routes.