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The authors calculated the BOLD-dependent MR imaging artifact impact arising from surgically implanted hardware through a retrospective analysis of fMRIs acquired from 2006–2014. Mean artifact volume associated with intracranial hardware was 4.3 cubic centimeters. The mean artifact volume from extracranial hardware in patients with cerebrovascular disease was 28.4 cubic centimeters. Artifacts had no-to-mild effects on clinical interpretability in all patients with intracranial implants. Extracranial hardware artifacts had no-to-moderate impact on clinical interpretability. The exceptions to interpretability in the face of hardware were ventriculoperitoneal shunts, particularly those with programmable valves and siphon gauges, and large numbers of KLS-Martin maxDrive screws.