The aim of this study was to demonstrate that eloquent cortex and epileptic-related hemodynamic changes can be safely and reliably detected using simultaneous electroencephalography (EEG)–functional magnetic resonance imaging (fMRI) recordings at ultra-high field(UHF)for clinical evaluation of patients with epilepsy. Materials and methods Simultaneous EEG–fMRI was acquired at 7 T using an optimized setup in nine patients with lesional epilepsy. According to the localization of the lesion, mapping of eloquent cortex (language and motor)was also performed in two patients.