When observers must discriminate a weak sensory signal in noise, early sensory areas seem to reflect the instantaneous strength of the sensory signal. In contrast, high-level parietal and prefrontal areas appear to integrate these signals over time with activity peaking at the time of the observer's decision. Here, we used functional magnetic resonance imaging to investigate how the brain forms perceptual decisions about complex visual forms in a challenging task, requiring the discrimination of ambiguous 2-tone Mooney faces and visually similar nonface images. Face-selective areas in the ventral visual cortex showed greater activity when subjects reported perceiving a face as compared with a nonface, even on error trials. More important, activity was closely related to the time of the subject's decision for face judgments, even on individual trials, and resembled the time course of activity in motor cortex corresponding to the subject's behavioral report. These results indicate that perceptual decisions about ambiguous face-like stimuli are reflected early in the sensorimotor pathway, in face-selective regions of the ventral visual cortex. Activity in these areas may represent a potential rate-limiting step in the pathway from sensation to action when subjects must reach a decision about ambiguous face-like stimuli.