In this paper we present a case of “word-meaning deafness,” characterised by serious problems in the comprehension of spoken language, whilst repetition and writing words and non-words from dictation are preserved. This performance indicates the impossibility of correctly accessing phonological representation from the semantic representation of words. Neuropsychological evidence on specific alterations in word-meaning disorders is scarce, and this study contributes new findings with a Spanish-speaking patient. The nature of the processes involved in understanding language and the cerebral mechanisms that might be affected in each case were discussed, in accordance with current neuropsychological theories.