Introduction Autistic individuals often have difficulties with recognizing what another person is saying in noisy conditions such as in a crowded classroom or a restaurant. The underlying neural mechanisms of this speech perception difficulty are unclear. In typically developed individuals, three cerebral cortex regions are particularly related to speech-in-noise perception: the left inferior frontal gyrus (IFG), the right insula, and the left inferior parietal lobule (IPL). Here, we tested whether responses in these cerebral cortex regions are altered in speech-in-noise perception in autism. Methods Seventeen autistic adults and 17 typically developed controls (matched pairwise on age, sex, and IQ) performed an auditory-only speech recognition task during functional magnetic resonance imaging (fMRI). Speech was presented either with noise (noise condition) or without noise (no noise condition, i.e., clear speech). Results In the left IFG, blood-oxygenation-level-dependent (BOLD) responses were higher in the control compared to the autism group for recognizing speech-in-noise compared to clear speech. For this contrast, both groups had similar response magnitudes in the right insula and left IPL. Additionally, we replicated previous findings that BOLD responses in speech-related and auditory brain regions (including bilateral superior temporal sulcus and Heschl's gyrus) for clear speech were similar in both groups and that voice identity recognition was impaired for clear and noisy speech in autism. Discussion Our findings show that in autism, the processing of speech is particularly reduced under noisy conditions in the left IFG—a dysfunction that might be important in explaining restricted speech comprehension in noisy environments.