It has been suggested that the hippocampus selectively supports recollection and that adjacent cortex in the medial temporal lobe can support familiarity. Alternatively, it has been suggested that the hippocampus supports both recollection and familiarity. We tested these suggestions by assessing the performance of patients with hippocampal lesions on recognition memory tests that differ in the extent to which recollection and familiarity contribute to the recognition decision. When targets and foils are highly similar, prior evidence suggests that, on a forced-choice test in which targets are presented together with highly similar, corresponding foils (the FC-C format), performance is supported primarily by familiarity. By contrast, when targets are presented together with foils that are similar to other targets (the FC-NC format) or when memory is tested in a yes/no (Y/N) format, performance is based much more strongly on recollection. Accordingly, a finding that hippocampal damage impaired both Y/N recognition and FC-NC recognition but spared FC-C recognition would suggest that the hippocampus selectively supports recollection. We administered Y/N, FC-C, and FC-NC tests to five memory-impaired patients with circumscribed hippocampal lesions and 14 controls. The patients were impaired on all three types of recognition test, and there was no indication that the patients were disproportionately benefited or disproportionately impaired on any test. This pattern of performance suggests that the hippocampus supports both recollection and familiarity.