We describe a patient with phonological alexia caused by a small hemorrhage in the posterior-inferior portion of the left temporal lobe. The lesion induced a highly selective impairment of phonological reading without concomitant oral language deficits other than anomia for objects presented in the visual and tactile modalities. We propose that an intact dorsal pathway from inferior risual association areas to Wernicke's area via the angular gyrus could mediate reading by the lexical route, while damage to a ventral pathway disrupted the patient's ability to read nonwords. We suggest further that although visually and tactually presented objects could be recognized and both verbally and nonverbally identified, they could not be named because of a disconnection from the area of word representations. © 1987.