Bone scintigraphy with 99mTc-methylene diphosphonate is the most frequently performed procedure in routine nuclear medicine practice in Korea. Bone scintigraphy is an extremely sensitive procedure for evaluating a variety of skeletal disorders and has the advantages of whole body evaluation. The main indications for referral include screening of patients with malignancy, trauma, orthopedic problems, sports injuries, as well as endocrine and rheumatologic disorders. Recent advances in instrumentation and the subsequent improvement in image quality have allowed nuclear medicine physicians to provide more accurate bone scan interpretations. The unique diagnostic information provided by SPECT and new indications of bone scintigraphy have emerged. There is an increasing opportunity to use PET imaging with 18F or 18F-fluorodeoxyglucose for the evaluation of musculoskeletal diseases. The application of new radiopharmaceuticals has provided information on changes in pathophysiological and pathobiochemical process and allowed more specific diagnosis, particularly for infection and tumors. The correlative image interpretation with results of other nuclear medicine or radiological imaging modalities is important. The image registration using software or hardware fusion will provide a higher degree of diagnostic accuracy. The role of bone scintigraphy is still expanding and will remain as one of the most commonly performed nuclear medicine procedures because of its sensitivity, simplicity, and cost-effectiveness. With advances of new imaging technology and radiopharmaceuticals, the diagnostic algorithm should be reestablished.