A seven-year-old male child presented with swelling at the left temporal region. His skull X-ray was normal. A three-phase bone scan showed increased blood flow, soft tissue activity, and increased tracer concentration in the left temporal region. Single photon emission computed tomography (SPECT) imaging of the skull revealed full thickness involvement of the left temporal bone. Our case report shows that, in osteomyelitis of the skull, SPECT imaging provides significantly more information for identifying the extent and thickness of bone involvement.