Abstract: Occurrence of hypophosphatemic osteomalacia (HO) induced by administration of low-dose adefovir therapy is rare, and bone scintigraphy of the disease has rarely been reported. We report on bone scintigraphic findings in patients with HO. Multiple uptakes in ribs, spines, and lower extremities, suggesting multiple fractures, were observed on bone scintigraphy. Patients were diagnosed as HO associated with adefovir therapy. Owing to the same predilection sites, multiple uptakes on the axial skeleton can cause confusion with malignant metastatic disease; however, involvement of lower extremity skeletons can provide a scintigraphic clue for use in differentiation of HO from malignant osseous metastasis.