Tc-99m DTPA and I-131 OIH renography were performed simultaneously in a patient with hepatorenal syndrome. Blood flow was delayed and diminished bilaterally; there was Tc-99m DTPA and I-131 OIH retention in the parenchyma with no evidence of tracer retention in the collecting systems. The I-131 OIH renogram curve demonstrated a steadily rising pattern, whereas the Tc-99m DTPA curve demonstrated an initial vascular peak and was subsequently flat. There was no appreciable response to furosemide. These findings are not specific for hepatorenal syndrome, and the diagnosis is based on the characteristic clinical setting and the exclusion of other causes of renal failure. A brief literature review and a discussion of differential diagnosis are included.