Multivariate and single variable analyses were employed to investigate the recovery mode of aphasia in right-handed patients with putaminal hemorrhage on the left side. Speech disturbance was evaluated using the standard language test for aphasia (SLTA) at intervals of 1, 3 and 6 months after the ictus. Recovery was assessed in relation to age, gender, volume and location of hematoma, and treatment modalities. Extension of the hematoma into the corona radiata was the factor that dominated the prognosis of aphasia at all intervals during the follow-up period. Good recovery was documented in patients with less than 2 cm2 of the hematoma volume located in the corona radiata. Recovery was poor, however, in patients with more than 12 cm2 of the hematoma in the corona radiata. While aphasia continued to improve over 6 months after the ictus, recovery was more prominent in the first 3 months. Our study precisely demonstrated that the extension into the corona radiata independently and strongly influenced the outcome of aphasia in patients with left putaminal hemorrhage.