Episodic autobiographical memory (AM) allows one, through the recollection of sensory-perceptual details, thoughts and feelings, to become aware of an event as belonging to one's own past as well as being able to project into one's future. Because AM provides a sense of self-continuity, contributes to the integrity of the self, and helps predicting future experiences, any deficit of AM may have debilitating consequences for everyday life functioning. Understanding AM failure and the underlying neural mechanisms has the potential to shed light on brain reorganization mechanisms and engagement of compensatory processes. Functional magnetic resonance imaging (fMRI) provides the most promising imaging method to tackle these issues. We reviewed evidence from the few studies that used fMRI to investigate the functionality of the residual tissue, the neural reorganization and compensatory mechanisms in patients with neurological conditions due to impaired medial temporal lobe. Overall, these studies highlight the importance of the left hippocampus, which when atrophied and not functional leads to AM deficits but its residual functionality may support relatively normal AM recollection. When damaged hippocampal tissue is not functional, other brain regions (e.g. , the medial prefrontal cortex) may be involved to compensate impairment, but they appear generally ineffective to support detailed episodic recollection.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Functional magnetic resonance imaging; Autobiographical memory; Amnesia; Medial temporal lobe; Memory deficit; Reorganization Core tip: Functional magnetic resonance imaging investigations of patients with impaired autobiographical memory (AM) can greatly contribute to further our understanding of brain reorganization mechanisms and engagement of compensatory processes after damage to the medial temporal lobe. These investigations are reviewed here. Overall, they highlight the importance of the left hippocampus, which when atrophied and not functional leads to deficits in AM but its residual functionality may support relatively normal AM recollection. When damaged hippocampal tissue is not functional, other brain regions (e.g. , the medial prefrontal cortex) may be involved to compensate impairment, but they appear generally ineffective to support detailed recollection.Denkova EJ, Manning L. FMRI contributions to addressing autobiographical memory impairment in temporal lobe pathology.