We evaluated the scintigraphic findings of sonographically atypical hemangioma, that is, a hypoechoic or heterogeneously hypoechoic nodule which contains hypoechoic areas more than 40% of the volume, and compared it with those of sonographically typical hemangioma in 26 patients with 31 nodules. Sonographically atypical hemangioma were 13 in 11 patients and sonographically typical hemangioma were 18 the 15 patients. Dynamic blood flow, planar and SPECT blood pool imaging was performed. In atypical hemangioma, increased blood pool activity was seen in 11 of 13 nodules on SPECT and in 10 of 13 nodules on planar image and increased blood flow was seen in 4 of 13 nodules on dynamic blood flow study. No significant difference in detecting increased blood pool activity between sonographically atypical and typical hemangioma. In conclusion, Tc-99m-red blood cell SPECT is as useful in diagnosis of sonographically atypical hemangioma as in typical hemangioma and can be used as a confirmatory or complementary study.