Abstract: Bone epithelioid angiosarcoma (EA) is a highly malignant bone tumor of vascular endothelial origin. Bone EA is a rare disease in clinical practice. A case of femoral EA with ⁹⁹Tc^m-methylenediphosphonate (MDP) SPECT/CT was reported and reviewed in terms of clinical symptoms, laboratory examination, CT and ⁹⁹Tc^m-MDP SPECT/CT imaging, the imaging features of EA were summarized by literature review. ⁹⁹Tc^m-MDP SPECT/CT imaging is helpful for the detection of metastatic and the differential diagnosis of EA from other diseases, which has certain clinical significance.