99mTechnetium-hexamethyl propylene amine oxime (99mTc HMPAO) white cell scintigraphy is increasingly used in the investigation of inflammatory bowel disease. It is now an accepted technique in the assessment of patients with colitis, although its role in small bowel is less clear. A retrospective study was performed on patients with jejunal and ileal Cröhn's disease to assess the sensitivity, reliability and usefulness of this technique in small bowel disease. Tc HMPAO scintigraphy was compared with barium studies, clinical outcome and, where available, subsequent histology. Good correlation between this technique and barium studies was found in 14 out of 18 patients and additional information was provided in two patients. A single false positive scan highlights the importance of early scanning in avoiding errors of interpretation due to the normal hepatobiliary excretion of activity that occurs with this pharmaceutical.