Adrenocortical carcinoma is a rare malignancy in childhood and often presents with a large abdominal mass and precocious puberty. The tumor is often advanced at the time of diagnosis. Radiological techniques are the main imaging modalities for assessment of the primary tumor. Ga-67 scintigraphy has been used in other pediatric solid tumors, however, no data were available for this tumor in childhood. A case of a 2.5-year-old male with a Ga-67 avid adrenocortical carcinoma is reported in which Ga-67 scintigraphy was very useful in detecting recurrence of the tumor and in assessing response to therapy.