Single photon emission computed tomography (SPECT) is a valuable addition to bone scintigraphy. SPECT removes from the diagnostic image unwanted activity which originates from in front and behind the tomographic plane of medical interest. This tomographic procedure allows one to examine with greater contrast and anatomic clarity such structures as the spine, hips, knees, and temporomandibular joints (TMJ). Abnormalities also seen on planar bone scintigrams often are more convincingly identified and better localized by SPECT. SPECT may even detect skeletal abnormalities not evident on planar views. These advantages of SPECT must be weighed against the superior resolution of planar bone scintigraphy. For this reason, SPECT complements, but does not replace planar bone scintigraphy. Including SPECT as an additional component of the skeletal examination does not place excessive demands on either gamma camera use or technologist time. Those nuclear medicine facilities offering bone SPECT for the evaluation of back, hip, knee, and TMJ pain should anticipate a larger volume of patient referrals.