Loss of sense of taste (hypogeusia) involving a part of the tongue can follow acute stroke. We describe a woman with a small right thalamic acute infarct causing bilateral (mainly left-sided) hypogeusia. Her problem remains sufficiently severe to cause distress and nutritional deficit. The anatomical distribution of her problem—cheiro-oral syndrome with concurrent hypogeusia—suggested involvement of adjacent relevant thalamic fibres. We address key considerations in examining taste in research and in practice and discuss issues to address in people with hypogeusia, including swallow deficits, psychological elements of the poststroke condition and nutrition. Dietetic management should include optimising taste stimuli and nutritional support. Introducing more detailed taste assessments into standard practice would likely improve stroke unit care.