We report the case of a patient, DRB, who shows impaired auditory comprehension of abstract but not concrete words, in the context of preserved comprehension of all types of written words. Good performance on auditory lexical decision for abstract words indicates that DRB is able to access these lexical entries. This pattern may be termed “abstract word meaning deafness.” Repetition is also more impaired for abstract words than concrete words. DRB is unable to repeat nonwords or write them to dictation. He makes semantic errors in real word repetition, which is compatible with the view that his repetition is semantically mediated. Exactly the same pattern of semantic errors and a particular difficulty with abstract words is found in tasks where DRB is required to write to dictation. DRB’s auditory comprehension and repetition impairments are not affected by word frequency. Performance on specific words is inconsistent, and is improved following a written cue.