The study uses an orthographic judgment task to evaluate the efficiency of the lexical reading route in Italian dyslexic children. It has been suggested that Italian dyslexic children rely prevalently on the sub-word-level routine for reading. However, it is not easy to test the lexical reading route in Italian directly because of the lack of critical items (irregular words), so visual lexical decision tasks and the comprehension/detection of pseudo-homophones are often used. While the former may also be solved on the basis of visual familiarity or phonological re-codification, the latter also involves conceptual and syntactic skills. Eleven dyslexic children participated in the study, performing an orthographic judgment task on stimuli with two phonologically plausible spellings, of which only one was orthographically correct. Their performance was compared with those of 11 proficient readers. The dyslexic children showed selective impairment in detecting phonologically plausible errors, but their performance was normal when required to judge errors inserted in words with regular orthography, i.e., devoid of orthographic ambiguity, and for which a sub-word-level reading procedure is sufficient to guarantee a good performance. Overall, data are coherent with a diagnosis of surface dyslexia, with most children showing defective orthographic lexical processing.