Randomly practicing a motor task is suggested to be superior for retaining that skill for future use in varying environmental contexts. PURPOSE: The purposes of this paper are to explore the rationale behind random practice and to examine the impact of random practice on the acquisition of skills in a patient with neurologic impairment. SUBJECT: Seventy-seven-year-old female patient with neurological and cognitive deficits admitted to an inpatient rehabilitation facility following a right cerebral vascular accident. METHODS: Instruction and random practice of compensatory techniques to address impairments were performed daily for 3 weeks. Outcomes were based on two criterion tasks, obstacle and step negotiation, that this patient had difficulty performing. RESULTS: This patient demonstrated 50% and 100% improvements on criterion task 1 and 2 (respectively) after 2 weeks of intervention. Improvements continued on 4-week retention tasks. CONCLUSION: Despite cognitive and neurological deficits, random practice had positive effects on this patient's performance. It appeared to enhance her ability to successfully utilize compensatory techniques acquired in therapy.