Scapular notching (SN) is a unique complication in reverse shoulder arthroplasty, caused by repetitive impingement of the humeral polyethylene liner against the inferior scapular neck. It occurs in up to 96% of cases, with bone loss beneath the glenoid baseplate and polyethylene wear. SN can be associated with pain, decreased range of motion, and might result in glenoid implant failure. Modification of glenosphere design and humeral neck angle showed substantially less SN. SPECT/CT is a promising tool providing combined morphologic and metabolic information in symptomatic SN. We present SPECT/CT findings in 7 cases of symptomatic SN in reverse shoulder arthroplasty patients.