Preparation for reaches to visual targets depends on sensorimotor transformations (SMT) between target and limb coordinate systems. To examine neural substrates for SMT, we studied 19 individuals with focal lesions of the visual association cortices and white matter and 11 control subjects without brain lesions. SMT were assessed by measuring accuracy of reaches to remembered locations of visually presented targets. Results showed abnormally large SMT errors in all individuals with inferior parietal lobule (IPL) lesions and some subjects with lesions of the temporo-occipital regions and in occipital area 19. Types of abnormal errors (direction or distance) varied between subjects with similar lesions, e.g. IPL. Patterns of abnormality included dissociations of distance and direction errors and of constant and variable errors. These findings are compatible with the hypothesis of different systems for guiding distance and direction of reaches distributed among structures in superior and inferior visual association cortex.