Multisensory integration is a powerful mechanism for increasing adaptive responses, as illustrated by binding of fear expressed in a face with fear present in a voice. To understand the role of awareness in intersensory integration of affective information we studied multisensory integration under conditions of conscious and nonconscious processing of the visual component of an audiovisual stimulus pair. Auditory-event-related potentials were measured in two patients (GY and DB) who were unable to perceive visual stimuli consciously because of striate cortex damage. To explore the role of conscious vision of audiovisual pairing, we also compared audiovisual integration in either naturalistic pairings (a facial expression paired with an emotional voice) or semantic pairings (an emotional picture paired with the same voice). We studied the hypothesis that semantic pairings, unlike naturalistic pairings, might require mediation by intact visual cortex and possibly by feedback to primary cortex from higher cognitive processes. Our results indicate that presenting incongruent visual affective information together with the voice translates as an amplitude decrease of auditory-event-related potentials. This effect obtains for both naturalistic and semantic pairings in the intact field, but is restricted to the naturalistic pairings in the blind field.