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Right hemisphere dominance in face processing is well established and unilateral right inferior temporo‐occipital damage can result in prosopagnosia. Here, we describe a 21‐year‐old right‐handed woman with acute impairment in face recognition that selectively concerned unfamiliar faces, following a focal left lateral temporo‐occipital venous infarct. She was severely impaired in discerning that unknown people seen in everyday life were unfamiliar, although she had no difficulty recognizing familiar people. Thus, she had no prosopagnosia, but abnormal ‘hyperfamiliarity’ for unknown faces. Her difficulty was not accompanied by delusions or deficits in discrimination, identification or memory for faces. Standard neuropsychological testing showed that her recognition of familiar faces was entirely normal. By contrast, her sense of personally knowing faces was severely impaired when unknown faces evoked …