Two patients with known type 1 Gaucher's disease had signs and symptoms of osteomyelitis. Decreased perfusion and impaired uptake were seen on bone scan. Patient 1 had a culture-negative aspirate of the site. Patient 2 had no surgical procedures. Both improved on bed rest and nonsteroidal anti-inflammatory agents. It is difficult to distinguish osteomyelitis clinically from pseudo-osteomyelitis. The authors suggest that photopenia on bone scan performed within 1 to 3 days of presentation is suggestive of pseudo-osteomyelitis in Gaucher's disease.