Patients with left (i.e. language-dominant) temporal lobe epilepsy (TLE) typically report word finding difficulties. However, these deficits are not reliably detected with traditional visual object naming tests. We administered both visual and auditory naming tests to left and right TLE patients and normal controls. We hypothesized that an auditory naming test might be more sensitive since it better simulates the conditions under which word finding problems occur in daily living. The left TLE group obtained significantly lower scores than other groups on auditory naming, whereas their performance on visual naming was indistinguishable from that of right TLE patients and normals. Furthermore, whereas cut-off scores on the auditory naming task predicted seizure focus laterality in 85% of patients, performance on the visual naming task predicted laterality in only 60% of patients. These findings suggest that compared with visual naming, as assessed in the present study, auditory naming may more accurately characterize and lateralize TLE-associated language dysfunction. These results also propose a more complex understanding of word retrieval that incorporates modality and contextual information.