This paper re-examines theoretical constructs used in the analysis of Russian word stress, employing data from speakers with acquired surface dyslexia, a symptom which is characterised by impaired lexical access and preserved grapheme–phoneme correspondence rules. Russian stems have been traditionally analysed as lexically accented or unaccented, with a default rule deriving surface stress in the latter case. In the study reported here, we found no differences in the production of accented and unaccented stems. Instead, the analysis of errors revealed that the significant factors determining stress placement include stress neighbourhood and stress position. The speakers produced fewer errors in consistently spelled words, and there was a strong tendency to shift stress to the final syllable in consonant-final words, and to the penultimate syllable in vowel-final words. These results indicate that distributional properties play an important role in stress assignment in both accented and unaccented stem types.