Alexia Ashford, an antagonist of the survival horror video game Resident Evil Code: Veronica.
Alexia Wheaton, a character played by Katherine Heigl in the Disney film, Wish Upon A Star
Alexia Tarabotti, the main character in Gail Carriger's steampunk series The Parasol Protectorate
Alexia 'Lexi' Branson, character on CW's The Vampire Diaries
Alexia is a medical term for difficulty reading after a stroke.