In a patient with associative visual agnosia without alexia, there was bilateral infarction in the distribution of the posterior cerebral arteries, with corticosubcortical lesions in both occipitotemporal regions, sparing the corpus callosum. Bilateral loss of visual-limbic connections may underlie associative visual agnosia, and bilateral lesions of the inferior longitudinal fasciculi may be the necessary and sufficient lesions for this syndrome. Alexia was absent in this case, perhaps because the corpus callosum was intact.