Purpose: In this study, the authors assessed how the addition of intentional left-hand gestures to an intensive treatment for anomia affects 2 types of discourse: picture description and responses to open-ended questions. Method: Fourteen people with aphasia completed treatment for anomia comprising 30 treatment sessions over 3 weeks. Seven subjects also incorporated intentional left-hand gestures into each treatment trial. Results: Both groups demonstrated significant changes in trained items and improved naming of untrained items but no change in Western Aphasia Battery-Aphasia Quotient (WAB-AQ; Kertesz, 1982) scores. Changes in discourse were limited to the 3-month follow-up assessment. Several discourse measures showed significant improvements in the picture description task and declines during question responses. Additionally, the gesture group produced more words at each assessment, whereas the no gesture group produced fewer words at each assessment. These patterns led to improvements in picture descriptions and minimal declines in question responses in the gesture group. In contrast, the no gesture group showed minimal improvements in picture descriptions and production declines in question responses relative to pretreatment levels. Conclusion: The intensive treatment protocol is a successful method for improving picture naming even of untrained items. Further, the authors conclude that the intentional left-hand gesture contributed significantly to the generalization of treatment to discourse.