A 16-year-old adolescent girl post total thyroidectomy for papillary thyroid carcinoma presented for postsurgical radioablative therapy. A whole-body I scintigraphy revealed not only expected activity in the thyroid bed but also asymmetric tracer distribution in the mandible and 2 foci of increased I accumulation in the distal left lower extremity. SPECT/CT images localized the activity to the donor sites of an autologous left fibular bone graft, harvested 8 years earlier to repair her mandible. Our case demonstrates that iodine accumulation can occur at the site of bone surgery many years after intervention and should be differentiated from iodine-avid metastases.