Crossed aphasia results from a lesion in a non-dominant, right cerebral hemisphere. This kind of neurological damage is rare and raises a number of issues in relation to the distribution of speech-related cognitive functions. We present a case of a right-handed patient after acute ischemic stroke with crossed aphasia. In the discussion, we list a number of uncertainties which arise in this clinical case. The detection of crossed aphasia should be followed by an early speech and language therapy as well as a neuropsychological treatment with cognitive rehabilitation.