Objective To evaluate the clinical value of serum BUN, Scr, PTH and 99Tcm-MDP bone scan in patients with renal osteodystrophy. Methods 75 patients with chronic renal failure undertook the serum levels of BUN, Scr, PTH detection and 99Tcm-MDP bone scan within one week. According to the results of bone scan, image characteristics related to metabolic bone disease were assessed based on visual analysis and semi-quantitative score tool. Results Of all 75 patients, the average serum level of BUN was 20.31±7.95 mmol/L, serum level of Scr was 730.2±275.4μmol/L, and the average serum level of PTH for 69 patients was 1477.4±781.9 pg/mL. The total 30 patients had 5 metabolic image characteristics. The 32 patients, 11 patients and 2 patients had 4, 3, and 2 image characteristics, respectively. Semi-quantitative score result of 75 patients were ranged from 4 score to 10 score. Conclusion The serum levels of BUN, Scr and PTH combined with analysis of 99Tcm-MDP bone scan in patients with chronic renal failure may be helpful in the diagnosis and evaluation of renal osteodystrophy.