Significance A central issue in the neurobiology of reading is a debate regarding the visual representation of words, particularly in the left midfusiform gyrus (lmFG). Direct neural recordings, electrical brain stimulation, and pre-/postsurgical neuropsychological testing provided strong evidence that the lmFG supports an orthographically specific “visual word form” system that becomes specialized for the representation of orthographic knowledge. Machine learning elucidated the dynamic role lmFG plays with an early processing stage organized by orthographic similarity and a later stage supporting individuation of single words. The results suggest that there is a dynamic shift from gist-level to individuated orthographic representation in the lmFG in service of visual word recognition.