Since sign language conveys many grammatical relations by manipulating spatial relations, its study provides a unique opportunity to investigate cerebral specialization for language. Three deaf signers with damage to the left hemisphere were administered an array of formal sign language tests and a linguistic analysis of their spontaneous signing was performed. All three signers showed aphasia for sign language. Strikingly, in these patients, differential damage within the left hemisphere appeared to lead to selective impairment of the structural layers of sign language (e.g. lexicon versus grammar). These data provide the first demonstration of grammatical breakdown in sign language. Importantly, the language impairments of these patients stood in marked contrast to their relatively intact capacities to process nonlanguage visual-spatial relationships. These results suggest that the two cerebral hemispheres of deaf signers can develop separate specializations for linguistic and for visual-spatial processing, even for a visual-spatial language. They further suggest that the left hemisphere has an innate predisposition for language.