This study compared the ability of clinical and ecologic simulation measures to predict performance on environment-specific criterion measures of wayfinding. Thirty-one unilateral stroke participants comprised the right and left hemisphere groups (16 patients with left sided and 15 patients with right sided strokes). Participants completed a battery of clinical tasks (e.g., traditional paper-and-pencil measures of visualization, mental rotation, visual memory and spatial orientation), ecologic simulations (e.g., slide route recall and visualization of a model town from differing perspectives) and environment specific criterion tasks (e.g., route recall and directional orientation). The groups were equivalent in age, sex, education, handedness, and weeks since stroke. Both ecologic simulation tasks were found to have fairly good internal consistency and 1 simulation task was significantly related to real world wayfinding. Of the clinical tasks, 1 visual memory test was correlated with a directional orientation criterion task, but none correlated with route navigation ability. Results are consistent with literature purporting the benefits of ecologic simulation tasks as predictors of real world functioning. (JINS, 2001, 7, 675–682.)