In order to better understand how concepts might be represented in the brain, we used a cross-modal conceptual priming paradigm to examine how repetition-related activity changes in the brain are related to conceptual priming. During scanning, subjects made natural/manmade judgments on a continuous stream of spoken nouns, written nouns and pictures of objects. Each stimulus either repeated in the same or a different modality with 1–4 intervening trials between repetitions. Behaviorally, participants showed significant perceptual and conceptual priming effects. The fMRI data showed that the conditions associated with the greatest behavioral priming exhibited the largest decreases in BOLD activity in left perirhinal cortex (PRc), as well as a few other regions. Furthermore, the PRc was the only region to show this relationship for the cross-modal conditions alone, where the concept but not the percept repeated. Conversely, repetition-related increases in PRc activity predicted better subsequent memory as assessed by a post-scan recognition test. These results suggest that repetition-related activity changes in the PRc are related both to the speed of access to a repeated concept and to that concept's later memorability.