Previous studies demonstrated that a region in the left fusiform gyrus, often referred to as the 'visual word form area' (VWFA), is responsive to written words, but the precise functional role of VWFA remains unclear. In the present study, we investigated the influence of orthographic similarity, and lexical factors on the multivoxel response patterns to written stimuli. Using high-resolution fMRI at 7T, we compared the organization of visual word representations in VWFA to the organization in early visual cortex and a language region in the superior temporal gyrus. Sets of four letter words and pseudowords were presented, in which orthographic similarity was parametrically manipulated. We found that during a lexical decision task VWFA is responsive to the lexical status of a stimulus, but both real words and pseudowords were further processed in terms of orthographic similarity. In contrast, early visual cortex was only responsive to the visual aspects of the stimuli and in the left superior temporal gyrus there was an interaction between lexical status and orthography such that only real words were processed in terms of orthographic similarity. These findings indicate that VWFA represents the word/non-word status of letter strings as well as their orthographic similarity.