Abstract: A case of hypercalcemia caused by multiple bone metastases from Ewing sarcoma was reported. Hypercalcemia caused by malignant tumor is not uncommon, but the microcalcification of malignant bone tumor with hypercalcemia in this case is typical and rare in the whole body bone imaging. The authors discussed the limitations of whole-body bone imaging in this case, and pointed out that the sensitivity of bone imaging for multiple metastatic microcalcifications of malignant tumors is superior to that of other imaging examinations, which is also worthy of attention of nuclear medicine and clinicians.