Background: Considerable spontaneous recovery is observed in aphasia, but impaired communication ability remains a great problem. Almost half of the patients still have aphasia one year after stroke onset, but usually in a milder form. Aim: The aim of this study was to assess the effect of very early intensive speech and language therapy (SLT) and correlate it with the location of the cerebral infarction in acute ischemic stroke patients with aphasia.Methods & Procedures: In this randomised study, 118 patients with acute cerebral infarction and aphasia were included and assigned either for three weeks of intensive SLT or part of the control group. The patients were evaluated by a speech therapist regarding aphasia with two language tests, Norsk Grunntest for Afasi and Amsterdam-Nijmegen Everyday Language Test in the acute phase, after three weeks and after six months. All patients were radiologically examined in the acute phase and after three weeks. Outcomes & Results: A total of 14 of 18 (78%) speech and language trained patients with infarction involving Wernicke's and central areas, but with intact Broca's area showed significant improvements of aphasia compared to 4 of 16 (25%) in the control group (p < 0.01). Patients with no visible radiological infarct had less severe initial language impairment and all of them in the training group showed significant improvements of aphasia.Conclusions: Patients with radiologically proven cerebral infarct involving Wernicke's area with or without infarctions centrally can benefit from early intensive SLT.