The present study aimed to examine the relationship between activation induced by an orthographic lexical retrieval (OLR) task and performance across time on the standard clinical version of OLR, the Controlled Oral Word Association Test (COWAT). The number of significantly activated pixels in a frontal lobe region of interest (encompassing middle and inferior frontal gyri) were measured for the left and right cerebral hemispheres in 20 volunteers. A relationship between the pixel count and the total number of words retrieved during the COWAT was found for the left but not the right hemisphere. Further examination of the left-sided relationship showed that the number of pixels in the left middle frontal region of interest correlated significantly with the second, but not the first, 30-s COWAT epoch. By contrast, the first epoch, but not the second, correlated significantly with the pixel count within the left inferior frontal region of interest. These relationships suggest differential involvement of dorsolateral and ventrolateral prefrontal cortex in specific cognitive processes fundamental to the production of language. Interindividual variation in activation levels may reflect underlying differences in cognitive processing capacity. This study is the first attempt to examine the relationship between fMRI activation and standard verbal fluency performance.