To investigate how auditory input from each ear contributes to spoken language processing, cortical activation by monaural speech sound stimulation was examined in 12 normal subjects using 15O-labeled water positron emission tomography. Regional cerebral blood flow (rCBF) was measured under four different sound stimulation conditions: (1) silence, (2) white noise, (3) sequential Japanese sentences ("speech"), and (4) Japanese sentences played backward ("reversed speech"), and the results were evaluated by statistical parametric mapping (SPM). Noise induced significant rCBF increase in the contralateral Heschl's gyrus. Speech and reversed speech stimuli caused significant rCBF increase in the contralateral Heschl's gyrus and the bilateral superior temporal gyri, with contralateral activation broader than that in the ipsilateral hemisphere. Monaurally input speech sound signals that reach the contralateral Heschl's gyrus may be processed chiefly and phonologically in the surrounding superior temporal gyrus in the same hemisphere. Comparison of speech activation with reversed speech activation failed to demonstrate a significant difference, which made it difficult to identify the area for lexical and semantic processing.