Over the last few decades, the number of studies concerning the role of subcortical structures in cognition has increased due to advances in neuroimaging. We describe the language and speech disturbances found in 16 patients with subcortical lesions (9 in basal ganglia and 7 in thalamus), evaluated by CT scan, MRI, and SPECT. Language assessment included the Boston Diagnostic Aphasia Examination, Boston Naming Test, and Token Test. Motor–articulatory alterations predominated in the non-thalamic group; in the thalamic group, there was a higher frequency of language alterations, especially in naming and auditory comprehension; verbal memory and attentional impairments may have contributed to this. We also found hypoperfusion in cortical language areas, and therefore participation of cortical dysfunction cannot be ruled out.