Despite anecdotal data on lexical interference among the languages of multilingual speakers, little research evidence about the lexical connections among multilinguals’ languages exists to date. In the present paper, two experiments with a multilingual speaker who had suffered aphasia are reported. The first experiment provides data about inter-language activation during natural conversations; the second experiment examines performance on a word-translation task. Asymmetric patterns of inter-language interference and translation are evident. These patterns are influenced by age of language learning, degree of language recovery and use, and prevalence of shared lexical items. We conclude that whereas age of language learning plays a role in language recovery following aphasia, the degrees of language use prior to the aphasia onset and of shared vocabulary determine the ease with which words are accessed. The findings emphasize the importance of patterns of language use and the relations between the language pair under investigation in understanding lexical connections among languages in bilinguals and multilinguals.