A psychotic woman with Capgras symptoms is presented in whom evidence of cerebral dysfunction is documented both by neuropsychological and neurophysiological findings. The possible etiological aspects of these symptoms are discussed. The main conclusion arrived at is that Capgras symptoms cannot be explained either on the basis of cerebral dysfunction alone or on the basis of a psychosis alone. The simultaneous presence of cerebral dysfunction and psychosis is necessary for the development of symptoms.