A male with developmental dysphasia is documented with fine motor dysfunction whose improvement in expressive language was associated with increased cerebellar perfusion, as detected by serial N-isopropyl-p-[iodine-123] iodoamphetamine single photon emission computed tomography (SPECT). His expressive language has been improving since 6 years, 8 months of age, and his verbal intelligence quotient improved from less than 45 at 5 years of age to 80 at 8 years of age. Compared with the SPECT findings at 4 years of age, the ratio of the average pixel values of the cerebellum to the frontal cortices increased at 9 years of age (from 0.81 to 1.03–1.09 in the hemisphere and from 0.66 to 0.98 in the vermis). However, he was not able to understand stories presented orally even at 9 years, 4 months of age. These results suggest that developmental dysphasia, which mostly involves expressive impairment, in this patient could have been the result of delayed maturation of cerebellar function, mainly that of the vermis.