ABSTRACT Although listening to speech and reading text rely on different lower-order cognitive and neural processes, much of the literature on higher-order comprehension assumes engagement of a common conceptual-semantic system which is unaffected by input modality. However, few studies have tested this assumption directly. Moreover, many neuroimaging studies of reading present sentences in an artificial, cognitively demanding word-by-word rapid serial visual presentation (RSVP) format. We report behavioural and fMRI experiments investigating whether presentation format (Spoken, Written, or RSVP) modulates commonly reported behavioural and neural costs associated with reinterpretation of sentences that contain lexical ambiguities. Reinterpretation-related processing costs were exaggerated in the RSVP format, both for response times on a behavioural task and neural activation in left inferior frontal gyrus. Presentation format can interact with higher-order language processes in complex ways, and we urge language researchers to carefully consider the role of presentation format in study design and interpretation of research findings.