Abstract: Acute pyelonephritis is a common disease in urinary system and can results in the irreversible renal parenchyma lesions-renal scarring and lead to a series of complications, such as hypertension, chronic renal failure and so on. Renal scarring can be prevented or diminished by early diagnosis and treatment of acutepyelonephritis. Radionuclide renal cortical scintigraphy is a good imaging method. Renal cortical scintigraphycan be used in early diagnosis and evaluation of therapy of acute pyelonephritis. This article reviews the role of renal cortical imaging in acute pyelonephritis.