The amygdala, situated in the anterior medial temporal lobe (MTL), is involved in the emotional enhancement of memory. The present study evaluated whether anterior MTL-resections attenuated arousal induced memory enhancement for pictures. Also, the effect of MTL-resections on response latencies at retrieval was assessed. Thirty-one patients with unilateral MTL-resections (17 left, 14 right) together with 16 controls participated in a forced choice memory task with pictorial stimuli varying in arousal. Response latencies increased with stimulus arousal in controls but not in patients. This was paralleled by attenuated recognition memory for moderately and highly arousing pictures in MTL-resectioned patients as compared to healthy controls. However, patients and controls did not differ in memory performance for non-arousing pictures. These results suggest that the MTL is necessary for arousal induced memory enhancement.