Despite a substantial body of work comprising theoretical modeling, the effects of medial temporal lobe lesions, and electrophysiological signal analysis, the role of the hippocampus in recognition memory remains controversial. In particular, it is not known whether the hippocampus exclusively supports recollection or both recollection and familiarity-the two latent cognitive processes theorized to underlie recognition memory. We studied recognition memory in a large group of patients undergoing intracranial electroencephalographic (iEEG) monitoring for epilepsy. By measuring high-frequency activity (HFA)-a signal associated with precise spatiotemporal properties-we show that hippocampal activity during recognition predicted recognition memory performance and tracked both recollection and familiarity. Through the lens of dual-process models, these results indicate that the hippocampus supports both the recollection and familiarity processes.hippocampus | recognition memory | recollection | familiarity | high-frequency activity R ecognition is one's ability to judge an item as previously encountered. Whereas it is well known that the hippocampus plays a crucial role in human recall memory, the role of the hippocampus in recognition memory remains surprisingly controversial (1-4). A number of studies have reported that bilateral hippocampal injury in humans causes impaired recall, whereas recognition remains intact (5). Others document the preservation of recognition in the setting of hippocampal lesioning in nonhuman primates (6) and rodents (7). On the other hand, a substantial literature describes combined recall and recognition deficits in a similarly injured group of patients (8) and animals (9, 10).Recognition is thought to rely on two processes: familiarity, wherein upon seeing a person's face, the rememberer has only a vague sense he has met the person before, and recollection, wherein the subject sees the person's face and vividly remembers details of the encounter (11,12). What role the hippocampus plays in supporting these processes remains the subject of considerable debate. Many memory researchers have proposed the discrepancy in the lesion data above derives from the fact that the hippocampus, which is well known to play a role in associative and relational memory (13), exclusively subserves recollection, whereas familiarity is supported by the extrahippocampal medial temporal lobe (MTL) (14). By this account, humans and animals are able to compensate for the loss of the hippocampus, and thus recollection, by relying on familiarity (15-18). A contrasting view holds that the hippocampus instead contributes to both recollection and familiarity, thus explaining why hippocampal damage is associated with severe impairment of both processes and consequently the overall recognition performance (4,8,19,20). Whether neural circuitry underlying familiarity and recollection lie within the hippocampus has also been extensively studied using functional MRI (fMRI) (21). Still, that many fMRI experiments show that ...