A 72-year-old right-handed woman developed aphasia after a left supplementary motor area (SMA) infarct. She had a right hemiparesis, more paretic on the leg, a tendency to look to her left, and loss of spontaneity. Neuropsychological deficits were mainly in the initiation of language production. She did not speak spontaneously, but responded and articulated well to questions. She named objects correctly when presented, and could repeat words, phrases, and sentences well. She had a difficulty in reading aloud, writing spontaneously and writing to dictation, but preserved the ability to copy written material. This is another rare case of SMA aphasia.