An osteoid osteoma of the femoral neck in a 7-year-old girl was successfully excised using intraoperative99mTc bone imaging. Since the nidus of the lesion was not seen with conventional radiography, linear tomography, and computed tomography, these techniques could not be used during surgery to localize the lesion or to indicate when its removal was complete. Postoperative bone imaging demonstrated that avascular necrosis of the femoral head had not occurred.