A stripe sign in pulmonary perfusion imaging is reported to be predictive of the absence of pulmonary embolism in the specific area of the stripe sign, and generally does not change on serial pulmonary perfusion imaging. The authors present the case of a patient with a stripe sign that disappeared on serial perfusion imaging without a ventilation abnormality. A "changing stripe sign" may raise suspicion for the possible existence of acute pulmonary embolism.