Neuromotor disorders due to ischemic stroke often affect articulatory control, especially tongue movements that play a crucial role in the production of speech sounds. In Arabic phonetics, the phoneme [ɾ] is a letter of al-lisān that relies heavily on the precision of tongue tip movement against the alveolar ridge. However, studies specifically examining the articulatory realization of this phoneme in post-ischemic stroke patients during controlled recitation of the Qur’an are still relatively limited. This study examines the effect of variations in vowels, namely fathah, kasrah, and dhammah, on the production of the phoneme [ɾ] in a post-ischemic stroke patient. The study used a qualitative case study design based on Peter Ladefoged’s Articulatory Phonetics theory. Data were obtained through recordings of participants’ recitations, then analyzed in Praat to identify acoustic parameters, including duration, fundamental frequency (F0), intensity, and formant patterns. The results showed that the production of the phoneme [ɾ] experienced changes in acoustic characteristics with each variation of the vowel. The dhammah /ru/ variation shows the most prominent deviation through duration lengthening and acoustic instability, while the kasrah /ri/ shows duration shortening accompanied by a decrease in sound energy. These findings indicate impaired articulatory coordination, particularly in tongue-tip movement and oral resonance stability. This research contributes to the development of clinical phonetic studies and to the objective evaluation of speech disorders through acoustic analysis.