Avascular necrosis of bone may affect specific areas of the body where the blood supply to the bone or part of the bone is vulnerable to injury or disease. In the carpal scaphoid, it can find this entity consequent a trauma, microtrauma, or fractures, especially in the proximal pole (Preiser in Fortschr Geb Roentgenstr 15:189-197, 1910), associated with a systemic disease, steroid ingestion (Ferlic and Morin in J Hand Surg-A 14:13-16, 1989), chemotherapy (Green in Hand Clinic 3:163-168, 1987) or a hypoplastic scaphoid (Gunal et al., in J Hand Surg-B 20(6):736-740, 1995). Preiser's disease is a rare entity and is commonly associated with avascular necrosis of the scaphoid without fracture or trauma. A case of bilateral idiopathic avascular necrosis of the scaphoid is reported.