Two hypotheses about the role of the ventromedial prefrontal cortex (vmPFC) in narrative comprehension inferences, global semantic coherence versus socio-emotional perspective, were tested. Seven patients with vmPFC lesions and seven demographically matched healthy comparison participants read short narratives. Using the consistency paradigm, narratives required participants to make either an emotional or visuo-spatial inference, in which a target sentence provided consistent or inconsistent information with a previous emotional state of a character or a visuo-spatial location of an object. Healthy comparison participants made the inferences both for spatial and emotional stories, as shown by longer reading times for inconsistent critical sentences. For patients with vmPFC lesions, inconsistent sentences were read slower in the spatial stories, but not in the emotional ones. This pattern of results is compatible with the hypothesis that vmPFC contributes to narrative comprehension by supporting inferences about socio-emotional aspects of verbally described situations.