Based on an experimental study, Jones-Gotman and Milner demonstrated that patients with right frontal lobe lesions were impaired on design fluency. We sought a clinical adaptation and developed a psychometrically sound technique for design fluency. The present study explores the validity of the Ruff Figural Fluency Test (RFFT) in discriminating patients with either right frontal or nonright frontal lobe lesions. In the first of two studies, six subjects with circumscribed focal lesions were given the RFFT and the Jones-Gotman and Milner figural fluency task. In the second study, we identified a larger sample of 30 patients with focal lesions in the right frontal, left frontal, right posterior, or left posterior cortex. The results from both studies support the validity of the RFFT as a measure which is sensitive to right anterior dysfunction.