Two recent advances have significantly improved the ability of labeled red cell imaging to localize and to detect sites of active gastrointestinal bleeding. The first is the use of continuous dynamic imaging. The second is the commercial availability of an in vitro red cell labeling method that significantly improves image quality. The computer equipment required for dynamic imaging is available in most nuclear medicine laboratories. Because cinematic display of the dynamic images increases the accuracy and ease of interpretation it should be considered the method of choice for performing gastrointestinal bleeding studies. High-risk patients can be identified if very active bleeding is noted early. However, a study with negative results, after monitoring the patient over 1 to 2 hours, suggests that conservative medical management may be adequate. Therefore, with proper use scintigraphy can provide both diagnostic and prognostic information to aid in the management of patients with gastrointestinal bleeding.