Background: Patient and Public Involvement (PPI) in aphasia research requires researchers to include people with aphasia as research partners from the beginning of the study. Yet the quality of reporting on the level and type of involvement is poorly documented in the absence of a framework to guide PPI in aphasia research. This study aimed to extract the items and statements relevant for the development of the People with Aphasia and Other Layperson Involvement (PAOLI) framework for designing and implementing PPI in aphasia research, in collaboration with people with aphasia. Method: The method recommended by the EQUATOR network was followed. This involved: (1) evidence from a scoping review, (2) a thematic analysis of the in-depth interviews, of people with stroke and aphasia, on the topics to be included in the pilot draft, (3) a two round Delphi survey for item/statement selection and (4) an experts' consensus meeting. The research team involved two PPI partners with chronic stroke-induced aphasia. The research process involved co-design and was informed by the Dialogue model. Results: Twenty-three panellists, from 13 countries, voted in round one with 87% (20/23) responding in round two. The final PAOLI framework includes the following 17 items (with 66 descriptive statements): establish collaborations, recruit patients, gain informed consent, organize induction meetings, train patient partners, create communication links, engage communication partners, conceptualize topics, establish research priorities, reach consensus, work with co-design methods, develop proposals, assist with dissemination of results, promote implementation of the outcomes, support patient partners and promote self-evaluation, monitor progress and assess impact of the patient involvement. These items were considered by the panellists as the most relevant for the involvement of people with aphasia as research partners. Conclusion: The PAOLI is the first international consensus framework for guiding patient involvement in aphasia research. Researchers are encouraged to adopt the framework to improve the quality of their research by promoting the meaningful involvement of people with aphasia within the research team from the start. Plain English Summary: Aphasia is a communication disorder which results in challenges with everyday interactions and impacts quality of life. Qualitative research involving people with aphasia often investigates quality of life. Until very recently people with aphasia were either excluded from such research teams or occasionally included as consultants but without their contribution documented or reported by the research team. The current work builds on evidence that has identified the absence of a standardized approach for designing and implementing the active involvement of people with aphasia in aphasia research teams. This approach was informed by patient participation involvement principles and the Dialogue model that involves engaging with patients/clients about such issues. This prompted the creation of the People with Aphasia and Other Layperson Involvement (PAOLI) framework, in close collaboration with people with aphasia. The research team involved two patient partners with chronic aphasia after stroke. To decide on the content to be included in the PAOLI framework a two-round international voting (Delphi survey), with 23 panellists from 13 different countries, and a meeting to finalize the framework were completed. The PAOLI includes 17 items (with 66 descriptive statements) on how to: establish collaborations, recruit patients, gain informed consent, organize induction meetings, train patient partners, create communication links, engage communication partners, conceptualize topics, establish research priorities, reach consensus, work with co-design methods, develop proposals, assist with dissemination of results, promote implementation of the outcomes, support patient partners and promote self-evaluation, monitor progress and assess impact of the patient involvement. These items were considered by the panellists as the most important for the involvement of people with aphasia as partners in research teams. The PAOLI is the first international framework for guiding patient involvement in aphasia research. Researchers are encouraged to use the PAOLI framework to improve the quality of their research by supporting the meaningful involvement of people with aphasia within their research team. [ABSTRACT FROM AUTHOR]