Introduction: Foreign accent syndrome (FAS) is a rare speech disorder. It is becoming increasingly common to find reports of cases about alterations different from the suprasegmental aspects of speech, although these reports are not frequent in Spanish-speaking patients.Case presentation: 48-year-old female patient from Colombia diagnosed with FAS, segmental and suprasegmental speech alterations, and changes in cognitive domains (executive functions and language). The woman also presented with motor and affective changes. Brain imaging studies ruled out structural involvement and follow-up at one year did not show significant changes in speech.Discussion: This case presents the neurological, neuropsychological and speech features of a Spanish-speaking patient with FAS. Greater alteration in vowels than in consonants, alteration in pronunciation time, variation in rhythm and intonation of words and phrases, decrease of time between syllables, and insertion of vowels are common elements between this patient and other cases of FAS in non-Spanish speaking subjects.Conclusions: FAS is essentially a speech alteration; however, it can be accompanied by other physical and psychological signs. This case report allows recognizing the essential components for the definition, diagnosis and intervention of this syndrome.