Communication disorders following stroke are common, but have varied presentations. This article explains the range of communication disorders that can occur after stroke. The effect of communication impairment is not always related to its severity and should be considered in terms of its effects on patient relationships and wellbeing, and healthcare delivery. Speech and language therapists have a key role in assessing, planning and delivering interventions for patients with communication impairment following stroke. However, it is vital that all members of the multidisciplinary team have sufficient awareness to recognise potential communication difficulties. It is hoped that with increased knowledge and awareness of communication impairment, healthcare staff can make full use of their skills as effective communicators to overcome any potential barriers to communication.