The objective was to compare the sensitivities for diagnosis of avascular necrosis of the femoral head of bone scintigraphy equipped with a pinhole collimator and with an high resolution parallel collimator. Bone scintigraphy equipped with a pinhole collimator and with an high resolution parallel collimator were performed in 16 patients with bilateral (n=7) or unilateral (n=9) avascular necrosis of the femoral head. Bone scintigraphy equipped with a pinhole collimator documented a photopenic defect in 78.3% of the necrotic hips, while bone scintigraphy equipped with an high resolution parallel collimator documented a defect in 47.8%. There was no false-positive diagnosis of avascular necrosis of the femoral head on either bone scintigraphy equipped with a pinhole or with an high resolution parallel collimator. In conclusion, bone scintigraphy equipped with a pinhole collimator has a greater sensitivity for diagnosis of avascular necrosis of the femoral head than bone scintigraphy equipped with an high resolution parallel collimator.