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Spatial relations between objects can be represented in a categorical and in a coordinate manner. Categorical representations reflect abstract relations, like ‘left of’ or ‘under’, whereas coordinate representations concern exact metric distances between objects. These two types of spatial relations are thought to be linked to a left hemisphere and a right hemisphere advantage, respectively. This lateralization pattern was examined in a visual search task, making use of natural scenes, in patients with unilateral brain damage and healthy controls. In addition, all participants performed a low-level spatial relation processing task. The results suggest that the lateralization pattern commonly found for spatial relation processing in low-level perceptual tasks is also applicable to the processing of complex visual scenes.