Purpose: To compare diagnostic performance of 18F-FDG PET/CT & I-131 MIBG in neuroblastoma osseous lesions. Materials and method: cross sectional study with 63 pathologically proved NB patients with dominating high risk category (~65.1 %) who underwent paired F-18 FDG PET/CT and MIBG scans (with maximum 2 weeks interval) using standard techniques for purpose of initial , post-therapy or follow up assessment. Clinico-pathological, radiological and follow up data were also collected. Results: On lesion based analysis of neuroblastoma bone metastases, though nonoptimum sensitivity was noted with both modalities yet statistically significant higher sensitivity was seen with 18F-FDG PET/CT (73.1%) as compared to that of I-131 MIBG (55.2 %) (p- Value=0.03). Higher (nonstatistically significant) specificity of 100% was seen with I-131 MIBG compared to 92.5% for FDG PET/CT (p-value=0.95). Conclusion: FDG PET/CT scanning may have an added value in detection of NB osseous lesions compared to I-131 MIBG, which may help to guide BMB (Bone Marrow Biopsy) in patients with either (I-131 MIBG or 18F-FDG PET/CT) positive scans.