The Boston Diagnostic Aphasia Exam and brief measures of memory, stereognosis, and limb praxis were administered to an extracranial-intracranial bypass surgery patient with moderately severe transcortical aphasia preoperatively and postoperatively. Significant improvement in language function was documented 2 days following surgery. Three month followup demonstrated continued improvement across all major areas of language function. These improvements were not felt to be attributable to practice effect, the natural remission of aphasic symptomatology or change in general medical status. Our experience with this patient leads us to speculate that patients with multivessel occlusive disease limiting cerebral oxygen supply to the vascular borderzone area may be more likely to benefit from bypass surgery and an increase in cerebral blood flow than some other subgroups of patients with cerebrovascular disorders.