David Cameron repeatedly mistook Teesside for Tyneside in a radio interview on Friday, just months after appearing to confuse Colchester and Chelmsford in Essex.
Speaking on BBC Tees, the prime minister was trying to list the government's economic achievements in the local area, but kept talking about investments that were reviving Tyneside, including a proposed tunnel under the river.
The presenter Lisa McCormick eventually highlighted his mistake, saying: "You keep mentioning the River Tyne. That's not our region, prime minister. I'm sorry, we are the River Tees."
Cameron appeared to think he was talking to a different radio station, as he replied: "I'm sorry, I thought I was doing … "
He then quickly pointed out that the government was investing £90m in the Tees Valley, which the presenter said "seems like a drop in the ocean" compared to £470m for Greater Manchester and £440m for the south-east.
He ended up having to reassure the programme's listeners that the government does care about the north-east. Only last year, the region was insulted when Conservative peer Lord Howell, George Osborne's father-in-law, implied it was a good place for fracking because it was "desolate".
Tom Blenkinsop, Labour MP for Middlesbrough South and East Cleveland, said Cameron was "out of touch" and disinterested in Teesside.
He said: "Over the last four years of David Cameron, we've had a Tory peer calling the region 'desolate', frequent misspellings of Teesside in official Number 10 letters and now the prime minister himself can't even take the basic cue of appearing on BBC Tees to get the hint that our river is the Tees and not the Tyne.
"This just highlights how David Cameron is out of touch with the region and completely disinterested in places like Middlesbrough, Stockton, Redcar, Hartlepool and East Cleveland."
During a BBC Essex interview in Colchester earlier this year, Cameron had to apologise after appearing to suggest he was in neighbouring Chelmsford.