Rotation of drawings has been described in focal brain lesions, at copy when the dorsal visual stream is involved, at recall in patients with memory or frontal dysfunction. In the present study Rey-Osterrieth Complex Figure performance was reviewed in 445 consecutive patients with mild cognitive impairment or degenerative dementia; a smaller sample (n = 243) had also performed the recall trial. Rotation was present in 19 cases overall: at copy in 11, at recall in 7, and at recall on a first assessment and at copy on retest in 1 last patient. Rotation at copy was often associated with neuropsychological and metabolic imaging evidence of parietal dysfunction, supporting previous evidence that rotation at copy might be due to an impairment of object perception processes within the dorsal visual stream. Rotation at recall seemed to be related predominantly to executive deficits, but no specific hypothesis on its cognitive origin can be advanced based on the present data.