Although visual motion processing is commonly thought to be mediated solely by visual cortical areas, this human lesion study suggests that the cerebellum also has a role. We found motion direction discrimination deficits in a group of patients with acute midline cerebellar lesions. Unlike normals and patients with hemispheric cerebellar lesions, these patients with midline lesions were unable to discern a global motion vector in a local stochastic motion display. This resembles the perceptual defect reported following cortical area MT lesions in primates. This motion perception deficit may result from damage to a cerebellar mechanism involved in perceptual stabilization. Disruption of this comparator mechanism is sufficient to produce a severe motion perception deficit even though cortical visual processing mechanisms are still intact.