A 41-year-old woman with focal epilepsy was analyzed immediately and 1 week post-ictally using pulsed-arterial-spin-labeling perfusion 3T MRI, a non-invasive method. Seizure-associated blood flow alterations were characterized by increased ictal perfusion in the occipito-parietal right cortex, and hypoperfusion in the same location 1 week later. These results indicate that non-invasive perfusion MRI can be used routinely to detect vascular alterations in epilepsy, and possibly to identify the location of the seizure focus.