Foreign accent syndrome (FAS) is a motor speech disorder in which changes to segmental as well as suprasegmental aspects lead to the perception of a foreign accent in speech. This paper focuses on one suprasegmental aspect, namely that of intonation. It provides an in-depth analysis of the intonation system of four speakers with FAS with the aim of establishing the intonational changes that have taken place as well as their underlying origin. Using the autosegmental-metrical framework of intonational analysis, four different levels of intonation, i.e., inventory, distribution, realisation and function, were examined in short sentences. Results revealed that the speakers with FAS had the same structural inventory at their disposal as the control speakers, but that they differed from the latter in relation to the distribution, implementation and functional use of their inventory. The current results suggest that these intonational changes cannot be entirely attributed to an underlying intonation deficit but reflect secondary manifestations of physiological constraints affecting speech support systems and compensatory strategies. These findings have implications for the debate surrounding intonational deficits in FAS, advocating a reconsideration of current assumptions regarding the underlying nature of intonation impairment in FAS. Learning outcomes: The reader will be able to (1) explain the relevance of intonation in defining foreign accent syndrome; (2) describe the process of intonation analysis within the autosegmental-metrical (AM) framework; and (3) discuss the manifestation of intonation changes in FAS at the different levels of intonation and their potential underlying nature. (Contains 4 tables and 4 figures.)