The Budd-Chiari syndrome is an uncommon clinical entity, in which invasive investigations are necessary to make a definitive diagnosis. Liver scintigraphy is a simple, safe, non-invasive screening test that can be performed when this diagnosis is suspected. If the appearance on the liver scan supports the diagnosis, further, more definitive, procedures can be undertaken. Four cases are reported to illustrate the role of liver scans in this condition. A case of superior vena caval obstruction which was diagnosed on a liver scan is also presented for comparison.