A considerable body of previous research on the prefrontal cortex (PFC) has helped characterize the regional specificity of various cognitive functions, such as cognitive control and decision making. Here we provide definitive findings on this topic, using a neuropsychological approach that takes advantage of a unique dataset accrued over several decades. We applied voxel-based lesionsymptom mapping in 344 individuals with focal lesions (165 involving the PFC) who had been tested on a comprehensive battery of neuropsychological tasks. Two distinct functional-anatomical networks were revealed within the PFC: one associated with cognitive control (response inhibition, conflict monitoring, and switching), which included the dorsolateral prefrontal cortex and anterior cingulate cortex and a second associated with valuebased decision-making, which included the orbitofrontal, ventromedial, and frontopolar cortex. Furthermore, cognitive control tasks shared a common performance factor related to set shifting that was linked to the rostral anterior cingulate cortex. By contrast, regions in the ventral PFC were required for decision-making. These findings provide detailed causal evidence for a remarkable functional-anatomical specificity in the human PFC.T he prefrontal cortex (PFC) is widely regarded as the pinnacle of brain evolution in humans (1). Its functional organization has long been under scientific scrutiny and has often been subsumed under the rubric "executive functions" (1, 2). Although some early theories attributed a unitary "central executive" to the PFC (3), scientific findings of the past decades have suggested that executive processes fractionate into distinct cognitive functions concerned with motivating behavior (valuation) and controlling behavior (cognitive control), which have been proposed to draw on two partially distinct PFC networks (1,(4)(5)(6). Comparative neuroanatomy suggests a functional and anatomical distinction between ventral PFC with strong connections to the limbic system and dorsolateral PFC (dlPFC) with connections to posterior cortical areas in the parietal lobe (7). Cognitive control, which is thought to draw on multiple processes, including task switching, response inhibition, error detection and response conflict, and working memory (2,4,8), has been associated with the dlPFC and the anterior cingulate cortex (ACC), as well as other sectors of the PFC that together may constitute a rostro-caudally organized hierarchy for behavioral control and planning (9-11). In contrast, valuation, reward learning, and decision-making functions have been mainly associated with ventral and medial sectors of the PFC (vmPFC) (10,(12)(13)(14)(15)(16)(17)(18). Overall, then, the broad functions of "cognitive control" and "valuation" appear to draw on partly distinct, but interacting, networks within the PFC to generate adaptive behavior (6,19,20), although this distinction is sometimes framed between various levels of control and motivation (20) or between executive functions (monitoring and task...