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We used event-related fMRI to investigate whether recollection- and familiarity-based memory judgments are modulated by the degree of visual similarity between old and new art paintings. Subjects performed a flower detection task, followed by a Remember/Know/New surprise memory test. The old paintings were randomly presented with new paintings, which were either visually similar or visually different. Consistent with our prediction, subjects were significantly faster and more accurate to reject new, visually different paintings than new, visually similar ones. The proportion of false alarms, namely remember and know responses to new paintings, was significantly reduced with decreased visual similarity. The retrieval task evoked activation in multiple visual, parietal and prefrontal regions, within which remember judgments elicited stronger activation than know judgments. New, visually different paintings evoked weaker activation than new, visually similar items in the intraparietal sulcus. Contrasting recollection with familiarity revealed activation predominantly within the precuneus, where the BOLD response elicited by recollection peaked significantly earlier than the BOLD response evoked by familiarity judgments. These findings suggest that successful memory retrieval of pictures is mediated by activation in a distributed cortical network, where memory strength is manifested by differential hemodynamic profiles. Recollection- and familiarity-based memory decisions may therefore reflect strong memories and weak memories, respectively.