We report on the first in-depth analysis of a specific type of dysnumeria, number-reading deficit, in sign language. The participant, Nomi, is a 45-year-old signer of Israeli Sign Language (ISL). In reading multidigit numbers (reading-then-signing written numbers, the counterpart of reading aloud in spoken language), Nomi made mainly decimal, number-structure errors– reading the correct digits in an incorrect (smaller) decimal class, mainly in longer numbers of 5–6-digits. A unique property of ISL allowed us to rule out the numeric-visual analysis as the source of Nomi's dysnumeria: In ISL, when the multidigit number signifies the number of objects, it is signed with a decimal structure, which is marked morphologically (e.g., 84 → Eight-Tens Four); but a parallel system exists (e.g., for height, age, bus numbers), in which multidigit numbers are signed non-decimally, as a sequence of number-signs (e.g., 84 → Eight, Four). When Nomi read and signed the exact same numbers, but this time non-decimally, she performed significantly better. Additional tests supported the conclusion that her early numeric-visual abilities are intact: she showed flawless detection of differences in length, digit-order, or identity in same-different tasks. Her decimal errors did not result from a number-structure deficit in the phonological-sign output either (no decimal errors in repeating the same numbers, nor in signing multidigit numbers written as Hebrew words). Nomi had similar errors of conversion to the decimal structure in number comprehension (number-size comparison tasks), suggesting that her deficit is in a component shared by reading and comprehension. We also compared Nomi's number reading to her reading and signing of 406 Hebrew words. Nomi's word reading was in the high range of the normal performance of hearing controls and of deaf signers and significantly better than her multidigit number reading, demonstrating a dissociation between number reading, which was impaired, and word reading, which was spared. These results point to a specific type of dysnumeria in the number-frame generation for written multidigit numbers, whereby the conversion from written multidigit numbers to the abstract decimal structure is impaired, affecting both reading and comprehension. The results support abstract, non-verbal decimal structure generation that is shared by reading and comprehension, and also suggest the existence of a non-decimal number-reading route.