The roles of planar and SPECT 99mTc labeled red blood cell (RBC) scintigraphy in the diagnosis of hepatic cavernous hemangioma were evaluated. Out of the 29 patients with various focal intrahepatic lesions 13 were diagnosed as having hemangiomas: 6 proven by surgery, and 7 proven by maintaining stable clinical course ranging from 6 to 12 month with no change in the size or appearance of the lesion on US. In the 13 patients a total of 16 hemangiomas were found. 12 of these detected by planar imaging, 2 detected by SPECT only. The sensitivity of planar RBC scintigraphy was 75%, the specificity was 100%. Although planar imaging is probably sufficient for all large or superficial hemangioma, delayed SPECT should be used with small (2-3 cm) or deeply seated lesions.