Two studies examined correlates of alexithymia in posttraumatic stress disorder (PTSD). In study 1 (n = 77 individuals with PTSD and 45 controls) Toronto alexithymia scale (TAS-20) scores were positively correlated with PTSD symptoms, dissociation, and childhood abuse and neglect. In study 2, TAS-20 scores were examined as correlates of functional magnetic resonance imaging (fMRI) blood oxygen level dependent (BOLD) response to trauma script imagery. In 16 controls, TAS-20 scores correlated positively with response in medial prefrontal cortex (mPFC), and negatively with response in anterior cingulate cortex (ACC) and thalamus. In 26 individuals with PTSD, TAS-20 scores correlated positively with response in insula, posterior cingulate cortex (PCC), and thalamus, and negatively with response in ACC.