Objective. To study an effect of stenosing lesions of carotid arteries on the recovery of speech functions in acute stroke patients. Material and methods. Medical histories of 253 patients (median age 58 [52,63]) with acute left hemispheric ischemic and hemorrhagic stroke and motor or sensorimotor aphasia were analyzed. The severity of atherosclerotic lesion of brachiocephalic arteries was assessed using color duplex scanning. According to the results of duplex scanning, patients were divided into 3 groups: 1 — without stenosis of extracranial arteries; 2 — with ≤50% stenosis of carotid arteries; 3 — with >50% stenosis of carotid arteries. Results. Stenosis greater than 50% (group 3) was a predictor of the poor recovery of speech function while stenosis less than 50% (groups 1 and 2) had no effect on the outcome. Conclusion. The severe atherosclerosis of carotid arteries had a negative effect on speech recovery in acute stroke patients.