Foreign accent syndrome (FAS) is an acquired neurogenic disorder characterized by altered speech that sounds foreign-accented. This study presents a British subject perceived to speak with an Italian (or Greek) accent after a brainstem (pontine) stroke. Native English listeners rated the strength of foreign accent and impairment they perceived in speech of the FAS subject, alongside that of two native English speakers and Italian, Greek, and French L2 speakers acting as controls. The FAS subject was perceived to be as foreign-sounding as the L2 control speakers, but was also perceived as mildly impaired. The FAS subject's own perception of accents was also explored and it was found that his ability to distinguish presence and absence of accent does not seem to be affected. The relationship between listeners' perceptions and features of the FAS speech is explored via correlational statistics and qualitative analysis. Impressionistic phonetic analysis, supplemented by acoustic analysis, confirmed a number of features consistent with a typical Italian (and also Greek) accent and the Italian and Greek L2 speakers. A pre-stroke and a post-stroke sample from the FAS subject were compared and the nature of post-stroke changes in segmental realizations is discussed. (Contains 4 tables and 11 figures.)