The significance and indications of MIBG scintigraphy are critically assessed. The results are compared with the results of whole-body bone scintigraphy, computed tomography (CT) and magnetic resonance tomography (MRT), and are related to values of catecholamine metabolites in 24-h urines. In our patients (10 histologically proven cases) MIBG scintigraphy turned out to be most useful in tumor follow-up. In contrast, the significance was much lower in primary tumor diagnosis and tumor staging as the exact primary diagnosis was established by other means such as CT, MRT, MDP whole-body scan, urine chemistry and bone marrow biopsy in all cases. MIBG scintigraphy in diagnostic imaging of neuroblastoma is an additive diagnostic tool and is called for in (1) tumour follow-up (progress, recurrencies, metastases); (2) primary diagnosis if the primary tumour has not been localized by means of CT or MRT; and (3) tumour staging to differentiate stage IV disease from lower stages as long as stage IV disease has not been established by bone-marrow biopsy or MDP whole-body scan.