We present a patient showing prominent prosodic deficits occurring in the early stage of AD, with regard to both visual and auditory emotional coding and decoding. In Task 1, prevalent recognition impairment was evident for Happiness (confused with Sadness and Surprise), Sadness (constantly confused with Neutral intonation and Happiness), and, finally, Neutral intonation (confused with Sadness and Happiness). In Task 2, Neutral expression was constantly confused with Sadness. These results could be explained by the association of “neutral” intonation (as well as “neutral” facial expression) with a reduction of melodic intonation (as well as reduction of facial expression), both typical of sadness also. On the other hand, misdiagnosing of surprise and happiness is evident in the auditory tasks, probably for the positive valence of both intonations, whereas, in the visual task, the act of “smiling” well distinguishes happiness from surprise. Task 3 showed deficits in repetition in all tasks except for Surprise, probably because of the strong pitch and intonation of such emotion, easier to repeat for the patient. Finally, Task 4 also showed a complete impairment on Happiness (100%) and a clear deficit to conveying Anger intonation: these deficits appear to be related to the difficulties in production of emotions that require strong intonation and tempo changes. In fact, in this task, only Neutral coding is correctly performed, obviously the only one that conveys absence of emotional sharing. A few studies, to our knowledge, have investigated the ability of emotional decoding through both auditory and visual modalities in AD; most of them lack the support of functional neuroimaging. Data in the literature are dissonant about facial expression recognition in AD6,7; the present case, instead, demonstrates that such impairment can occur early in the disease course, along with deficits in recognition of prosody; and shows that impairments in the auditory channel for many primary emotions seems to mirror impairments in the visual channel. Such conditions should be seriously considered by therapists and caregivers in order to improve communication and relationships with AD patients.