32 lesions in 30 patients with Hepatocellular carcinoma (HCC) were studied using gamma camera and technetium-99m metoxyisobutylisonitrile (99mTc-MIBI) to evaluate the pattern of uptake of 99mTc-MIBI in the lesions and the relationship between the uptake pattern and histopathology of HCC. All lesions were diagnosed as HCC by percutaneous needle biopsy. 14 of 32 lesions showed positive uptake of 99mTc-MIBI, while the other 18 showed negative uptake. All of the lesions which showed positive uptake were of the compact type. Of the 18 lesions that showed negative uptake, 17 were of the trabecular type while one was of the compact type (necrotic compact tumor). These results suggest that the pattern of 99mTc-MIBI accumulation in HCC is divided into positive and negative types and those uptake patterns are corresponded to tissue structure of HCC.