One of the most widely reported developmental deficits associated with autism is difficulty perceiving and expressing emotion appropriately. Brain activation associated with performance on a new task, the Emotional Congruence Task, requires judging affective congruence of facial expression and voice, compared with their sex congruence. Participants in this pilot study were adolescents with normal IQ (n = 5) and autism or without (n = 4) autism. In the emotional congruence condition, as compared to the sex congruence of voice and face, controls had significantly more activation than the Autism group in the orbitofrontal cortex, the superior temporal, parahippocampal, and posterior cingulate gyri and occipital regions. Unlike controls, the Autism group did not have significantly greater prefrontal activation during the emotional congruence condition, but did during the sex congruence condition. Results indicate the Emotional Congruence Task can be used successfully to assess brain activation and behavior associated with integration of auditory and visual information for emotion. While the numbers in the groups are small, the results suggest that brain activity while performing the Emotional Congruence Task differed between adolescents with and without autism in fronto-limbic areas and in the superior temporal region. These findings must be confirmed using larger samples of participants.