Randomization performance was studied using the "Mental Dice Task" in 20 patients with aphasia (APH) and 101 elderly normal control subjects (NC). The produced sequences were compared to 100 computer-generated pseudorandom sequences with respect to 7 measures of sequential bias. The performance of APH differed significantly from NC participants, according to all but one measure, i.e. Turning Point Index (points of change between ascending and descending sequences). NC participants differed significantly from the computer generated sequences, according to all measures of randomness. Finally, APH differed significantly from the computer simulator, according to all measures but mean Repetition Gap score (gap between a digit and its reoccurrence). Despite the heterogeneity of our APH group, there were no significant differences in randomization performance between patients with different language impairments. All the APH displayed a distinct performance profile, with more response stereotypy, counting tendencies, and inhibition problems, as hypothesised, while at the same time responding more randomly than NC by showing less of a cycling strategy and more number repetitions.