Abstract Italian polysyllabic words with stress falling on the last syllable are written with a diacritic sign on the last vowel. It allows discrimination between two words with the same orthographic segments (e.g., papa [pope], papà [dad]). The effect of the accent mark in left neglect dyslexia has never been investigated. In the current study, six patients with neglect dyslexia were asked to read aloud homographic words and non-words, with or without the accent mark. The presence of the accent improved reading performance of three patients but only with real words. In contrast, two patients ignored the accent mark, even if it relied on the right ipsilesional space. We conclude that the accent mark is computed separately from letter identity and that it can act as an important cue for lexical access.