Music, like language, is acquired effortlessly in early life and fulfils a multitude of social, cultural and emotional functions. However, those with a disorder recently termed ‘congenital amusia’ (CA) fail to recognise common tunes from their culture, do not hear when notes are ‘out of tune’ and sometimes report that music sounds like a ‘din’ or ‘banging’. The core deficit appears to be a problem in discriminating pitch direction, a building block for the representation of melodic contour. Familial studies suggest the disorder is heritable and associated with structural differences in temporal and frontal cortices. The disorder provides a window onto the neuro-cognitive architecture of musical processing, and the possible etiologies of disordered development.