Brain SPECT of regional cerebral blood flow using I-123 IMP demonstrated a focally decreased perfusion area immediately adjacent to a venous angioma in a patient with simple partial seizures. A positive correlation was obtained among the location of the venous angioma, the decreased perfusion area on SPECT images, and the electroencephalographic focus. Anomalous venous drainage through a venous angioma may explain a perfusion disturbance in the surrounding brain of the angioma. High-resolution SPECT imaging with magnetic resonance guidance provides useful information on the pathophysiology of venous angiomas.