The cognitive neuroscience of semantics has focused largely on object knowledge. By contrast, spatial semantics, especially as related to language, has received little attention. Spatial thought and language gives our semantic system a rich texture by introducing relational thinking and greater levels of abstraction than is evoked by object semantics. This article describes the neural instantiation of spatial thought and language based on imaging and lesion studies. We underscore two functional-anatomical organizational principles. First, perceptual and conceptual representations have a parallel organizational structure within the nervous system. Lateral temporal cortices are important for manners of motion, action representations, and action verbs. More dorsal regions are important for paths of motion, locative representations, and prepositions. Second, posterior perceptual representations serve as points of entry for more anterior and centripetally located peri-Sylvian conceptual and linguistic representations.