The purpose of the current study was to examine the performance characteristics of the Wechsler Spatial Span subtest in a mixed clinical sample. Contrary to expectation, differential patterns of performance were obtained on the Digit and Spatial Span tasks. Forward Digit Span scores were significantly higher than backward recall scores, but this was not the case for Spatial Span. There were no differences between forward and backward raw Spatial Span scores at the mean level. Further, about one third of the sample showed better performance on backward compared to forward Spatial Span. In addition, performance on the Spatial Span backward task correlated unexpectedly with that of the WMS-III Immediate and Delayed Auditory Index scores. Overall, the findings suggest that clinicians should be hesitant when interpreting the Spatial Span task, and the backward condition in particular, as a measure of working memory. Finally, methodological concerns with the Spatial Span task are noted, raising additional concerns regarding the meaning of this task.