Objective To Investigate the diagnostic value of 99Tcm-DX lymphoscintigraphy in lower limbs lymphedema as the initial symptom of lymphnode malignant tumor. Methods Twenty-one lymph node malignant tumor patients initially diagnosed as lymphedema were studied retrospectively. After the injection of 99Tcm-DX into the first interdigital space of both feet, lymphoscintigraphy was performed at 10 min, 1, 3 and 6 hour intermittently. Results Lymphoscintigrams were analyzed for visualization of lymphatics and lymph nodes, dermal backflow of radiotracers in all bodies. The main characteristics included the lymphatic blockage，lateral branch lymphatic，dermal backflow，non-imaging lymph nodes. Conclusion As a noninvasive, accurate and effective imaging modality, lymphangioscintigraphy may be the first choice for evaluating lower limbs lymphedema as the initial symptom of lymphnode malignant tumor.