Preference judgment, the process of selecting a response from several alternatives based on which alternative the subject likes best, is an important aspect of daily life. The current study examined whether neural substrates that are thought to be critical for generating somatic markers are involved in preference judgments. Fifteen healthy, right-handed subjects performed a preference judgment task during functional magnetic resonance imaging. The medial frontal gyrus was significantly more activated during the preference judgment trials, relative to visual discrimination trials. Other areas that were also differentially activated included the posterior parietal cortex, the anterior cingulate and the left anterior insula. These findings are consistent with the role of the ventromedial prefrontal cortex in the representation of complex appetitive states.