Tarsal coalition is abnormal fusion of two or more tarsal bones. The union may be fibrous, cartilaginous, or osseous and can be congenital or acquired in response to infection, articular disorders, trauma, or surgery. We report a case of fibrous talocalcaneal coalition in a 15-year-old boy in whom bone scintigraphy employing pinhole lateral views confirmed the clinical diagnosis when plain radiographs showed minimal changes and computed tomography was equivocal. The diagnosis of symptomatic tarsal coalition is important in that it is a common remediable cause of peroneal spastic flat foot, a frequently encountered condition. Scintigraphy provides important information about the presence and localization of this condition.