One theory about reading suggests that producing the correct pronunciations of written words, particularly less familiar words with an atypical spelling-sound relationship, relies in part on knowledge of the word's meaning. This hypothesis has been supported by reports of surface dyslexia in large case-series studies of English-speaking/reading patients with semantic dementia (SD), but would have increased credibility if it applied to other languages and writing systems as well. The hypothesis predicts that, of the two systems used to write Japanese, SD patients should be unimpaired at oral reading of kana because of its invariant relationship between orthography and phonology. By contrast, oral reading of kanji should be impaired in a graded fashion depending on the consistency characteristics of the kanji target words, with worst performance on words whose component characters take 'minority' (atypical) pronunciations, especially if the words are of lower frequency. Errors in kanji reading should primarily reflect assignment of more typical readings to the component characters in these atypical words. In the largest-ever-reported case series of Japanese patients with semantic dementia, we tested and confirmed this hypothesis. © 2008 Elsevier Ltd. All rights reserved.