The capacity of schizophrenia patients to make decisions regarding research consent relates to neurocognition, but the exact nature of the relationship is unclear. The authors examined the correlation of scores on the MacArthur Competence Assessment Tool for Clinical Research with functional magnetic resonance imaging brain response during a verbal learning task. Understanding of a consent form correlated with activation of the right hippocampus during verbal learning and with brain response in a large area that included the bilateral parahippocampus, cerebellum, and thalamus. Reasoning scores were not significantly related to brain activation. Understanding deficits during informed consent relates to particular brain abnormalities among schizophrenia patients.