Empathy refers to our ability to recognize and share emotions by another human being. Impairment may underlie many of the emotional deficits commonly associated with a range of neuropsychiatric and neurological conditions. The prefrontal cortex (PFC) has long been implicated in these processes, but the specific contribution of subregions of the PFC remain unclear. Studies regarding the role of subregions of the prefrontal cortex such as the ventromedial prefrontal cortex (vmPFC)—in facial emotion recognition have yielded inconsistent results. The present study aimed to investigate the capacity to recognize nonverbal emotional facial expressions in a group of patients with the following: (a) perfusion deficits in the vmPFC (vmPFC group; N = 13), (b) hypoperfusions sparing the vmPFC (nonvmPFC group; N = 12), and in (c) a control group of healthy volunteers (control group; N = 17). Regions of hypoperfusion were identified by means of Single Photon Emission Computed Tomography (SPECT). Participants were asked to recognize facial expressions of the 7 basic emotions (happiness, fear, surprise, anger, disgust, sadness, or neutral). Detection of facial expressions of fear, disgust, and surprise was affected after functional disruption of the vmPFC. The present study confirms the role of the vmPFC in recognizing emotional facial expressions.