Background: Human communication occurs through both verbal and visual/motoric modalities. Simultaneous conversational speech and gesture occurs across all cultures and age groups. When verbal communication is compromised, more of the communicative load can be transferred to the gesture modality. Although people with aphasia produce meaning-laden gestures, the communicative value of these has not been adequately investigated. Aims: To investigate the communicative effectiveness of pantomime gesture produced spontaneously by individuals with aphasia during conversational discourse. Methods & Procedures: Sixty-seven undergraduate students wrote down the messages conveyed by 11 people with aphasia that produced pantomime while engaged in conversational discourse. Students were presented with a speech-only, a gesture-only and a combined speech and gesture condition and guessed messages in both a free description and a multiple-choice task. Outcomes & Results: As hypothesized, listener comprehension was more accurate in the combined pantomime gesture and speech condition as compared with the gesture- or speech-only conditions. Participants achieved greater accuracy in the multiple-choice task as compared with the free-description task, but only in the gesture-only condition. The communicative effectiveness of the pantomime gestures increased as the fluency of the participants with aphasia decreased. Conclusions & Implications: These results indicate that when pantomime gesture was presented with aphasic speech, the combination had strong communicative effectiveness. Future studies could investigate how pantomimes can be integrated into interventions for people with aphasia, particularly emphasizing elicitation of pantomimes in as natural a context as possible and highlighting the opportunity for efficient message repair.