This special issue of Cognitive Neuropsychology is dedicated to a problem of considerable current interest: the role of phonology in orthographic lexical access. This problem has been the focus of much discussion in the normal literature, but has received only scant attention in cognitive neuropsychology. The standard position in cognitive neuropsychology has been that phonological mediation is not necessary (but may play a role) in orthographic lexical access. Why this difference in the two literatures? The reason seems to be quite simple, if not entirely justifiable. In the case of spelling, for example, the fact that in some brain-damaged subjects the ability to spell is often preserved even though phonological production may be quite severely impaired has been interpreted as indicating that spelling does not require phonological mediation. However, in order to reach this conclusion it would have to be shown that the phonological deficit in these subjects is not at a level of processing subsequent to the point where phonological mediation might take place, and this precaution has not always been faithfully observed. Thus, it is of considerable value to collect in one place reports that purport unambiguously to resolve the issue of phonological mediation in orthographic lexical access. Seven papers are included in this issue. Four of them (Hanley and McDonnell, Miceli, Benvegnù, Capasso and Caramazza, Rapp, Benzing and Caramazza, Shelton and Weinrich) report case studies purportedly showing that phonological mediation is not necessary in orthographic lexical access. The empirical reports are followed by commentaries by Van Order, Jansen op de Haar, and Bosman and by M. Coltheart and V. Coltheart on the issue of phonological mediation in reading, and a paper by Caramazza that interprets the patterns of dissociations and associations of lexical errors in speaking and writing as providing evidence against the existence of a modality-neutral level of lexical representation (lemma).