Semantic memory decline has been found in mild cognitive impairment (MCI). In this study performance on a range of semantic tasks and structural brain patterns were examined in a group of MCI patients. Fourteen MCI and sixteen healthy elderly controls underwent semantic memory assessment and MRI brain scanning. The cognitive battery included visual naming and naming from definition tasks for objects, actions and famous people, semantic fluency for animals, fruits, tools, furniture, singers, politicians, actions, word-association task for early and late acquired words and a reading task. MCI patients performed worse on semantic fluency in all categories except for tools, produced a smaller number of words associated with early acquired nouns and a smaller total number of word-associations. Patients scored more poorly in all tasks of naming, naming of famous people, overall reading and reading of famous people's names. MCIs had fewer correct immediate recalls and more correct responses with cue in famous people naming, made more errors in naming and in the naming from definition task for famous people. Grey matter reduction in parahippocampus, frontal and cingulate cortices and amygdala was found in the MCI sample when compared with controls. Patients presented a different pattern of brain areas correlated with semantic tasks from that seen in controls, with more extensive involvement of subcortical regions in semantic fluency and word-association and more contribution of frontal than temporo-parietal areas in visual naming. This evidence suggests a reorganization of cortical associations of semantic processes in MCI that, following damage in the semantic circuit, explains its progressive breakdown.