The impact of aphasia following stroke is devastating. Very early aphasia rehabilitation studies have been the subject of ongoing debate. This paper describes the comparison of a very early aphasia therapy regimen with a historical ‘usual care’ control group after therapy completion, at four to five weeks post stroke and again after six months. The authors found that an impairment-based aphasia therapy regimen, provided daily over 20 sessions (over four to five weeks) in very early stroke recovery, resulted in significantly greater communication gains in people with mild to severe aphasia. The study adds to the existing literature, suggesting that increased and intensive aphasia therapy in the very early recovery phases is important for improving the effects of spontaneous recovery.