Acquired dysfunction of the sense of smell and taste is usually associated with orbitofrontal tumors or trauma and is rarely reported to have occurred after ischemic stroke. We report on a patient who noted impairment of the sense of smell and taste after a localized insular frontoparietal stroke and who also had a similar, mirror-image infarction in the other hemisphere. Injury to an area of the cortex responsible for the integration of taste and smell may have accounted for this patient's symptoms.