Each action has sensory consequences that need to be distinguished from sensations arising from the environment. This is accomplished by the comparing of internal predictions about these consequences with the actual afference, thereby isolating the afferent component that is self-produced. Because the sensory consequences of actions vary as a result of changes of the effector's efficacy, internal predictions need to be updated continuously and on a short time scale. Here, we tested the hypothesis that this updating of predictions about the sensory consequences of actions is mediated by the cerebellum, a notion that parallels the cerebellum's role in motor learning. Patients with cerebellar lesions and their matched controls were equally able to detect experimental modifications of visual feedback about their pointing movements. When such feedback was constantly rotated, both groups instantly attributed the visual feedback to their own actions. However, in interleaved trials without actual feedback, patients did no longer account for this feedback rotation--neither perceptually nor with respect to motor performance. Both deficits can be explained by an impaired updating of internal predictions about the sensory consequences of actions caused by cerebellar pathology. Thus, the cerebellum guarantees both precise performance and veridical perceptual interpretation of actions.