Neuroimaging studies of patients with posttraumatic stress disorder (PTSD) have largely been performed in adult populations. The purpose of the current study was to investigate neural correlates of PTSD in adolescents. Specifically, this study investigates whether a differential brain response was present during the visual perception and imaginary recollection of traumatic reminders in adolescents who developed PTSD versus those who did not after experiencing earthquake. Eleven Taiwanese adolescents (age range: 12-14 years) with traumatic experience of earthquake were enrolled. Five subjects fulfilled PTSD criteria, while the other six served as non-PTSD controls. Brain activation was measured by functional magnetic resonance image (fMRI) during visual perception and imagery recall of earthquake and neutral pictures at 14 months after earthquake. During earthquake imagery (as compared with neutral imagery), PTSD group demonstrated activation in the bilateral visual cortex, bilateral cerebellum and left parahippocampal gyrus, while control group did not. During earthquake perception (as compared with neutral perception), the control group showed activation over anterior cingulate, but the PTSD group did not. Intergroup comparison confirmed above discrepancies was significant. We concluded that neurobiological alternation of PTSD in adolescent was similar to those in adult and might have developed within 14 months after trauma exposure.