Purpose: To determine the effect of personal relevance and contextualization of images on the preferences and word-picture matching accuracy of people with severe aphasia. Method: Eight adults with aphasia performed 2 experimental tasks to reveal their preferences and accuracy during word-picture matching. The researchers used 3 types of visual stimuli--personally relevant, contextualized photographs; non-personally relevant, contextualized photographs; and noncontextualized, iconic images--paired with 3 types of target words--labels of people or objects, actions, and socially relevant events--as the stimulus materials. Results: Data analysis showed that participants (a) preferred using personally relevant, contextualized photographs rather than other types of photographs/images to represent target words and (b) performed more accurate word-picture matching when presented with target words associated with personally relevant, contextualized photographs than target words associated with noncontextualized or nonpersonalized photographs/images. Conclusions: Clinically, the findings highlight the importance of using personally relevant, contextualized photographs rather than generic contextualized photographs or noncontextualized, iconic images to support the communication attempts of people with aphasia who cannot communicate effectively using natural speech alone. (Contains 3 tables and 2 figures.)