Vertebral hemangiomas are the most common benign tumors of the spine and usually present as cold defects on skeletal scintigraphy. However, these lesions may rarely show uptake of Tc-99m methylene diphosphonate, mimicking metastases. In this patient with renal carcinoma, abnormal vertebral tracer uptake (indicative of skeletal metastases on planar bone scintigraphy) was subsequently localized to vertebral lesions identified as hemangiomas on the CT component of single photon emission computed tomography/computed tomography (SPECT/CT). None of these hemangiomas showed any uptake of F-18 fluorodeoxyglucose on positron emission tomography/ computed tomography (PET/CT). How to cite this article Manohar K, Parghane RVR, Kumari S, Bhattacharya A, Mandal AK, Mittal BR. Multiple Vertebral Hemangiomas Mimicking Metastases in a Patient with Rena Carcinoma: Importance of Hybrid Imaging with SPECT/CT and FDG PET/CT. J Postgrad Med Edu Res 2012;46(4):196-197.