Recently, Hall et al. reported that ethidium (E+) is formed as a major product of hydroethidine or dihydroethidium (HE or DHE) reaction with superoxide (O2•–) in intact animals with low tissue oxygen levels (J Cereb Blood Flow Metab 32:23–32, 2012). The authors concluded that measurement of ethidium (E+) is an indicator of O2•– formation in intact brains of animals. This finding is in stark contrast to previous reports using in vitro systems (Zhao et al, Free Radic Biol Med 34:1359, 2003 and Dikalov et al, Hypertension 49:717, 2007) showing that 2-hydroxyethidium, not ethidium, is formed from the reaction between O2•– and HE. Published in vivo results support the in vitro findings. In this study, we performed additional experiments in which HE oxidation products were monitored under different fluxes of O2•–. Results from these experiments further reaffirm our earlier findings (Zhao et al, Free Radic Biol Med 34:1359, 2003). We conclude that whether in vitro or in vivo, E+ measured by HPLC or by fluorescence lifetime imaging, is not a diagnostic marker product for O2•– reaction with HE.