Bisphosphonates are well established ligands for 99m Tc for planar and SPECT/CT imaging of osteoblastic metastases. A novel DOTA-based bisphosphonate, (4-{[bis-(phosphonomethyl)) carbamoyl]methyl}-7,10-bis(carboxymethyl)-1,4,7,10-tetraazacyclododec-1-yl)acetic acid (BPAMD) [1,2] The advantages of this new bone imaging PET tracer are the very high target to soft tissue ratios and fast clearance, its ease of use and the generator-based availability of 68 Ga which becomes especially important in these days of 99m Tc shortage.While 18 F-fluoride is adsorbed on bone surface and is related to blood flow, the bisphosphonate [ 68 Ga]BPAMD is taken up also by osteoclasts reflecting the farnesyl diphosphate synthase enzyme dynamics in the HMG-CoA reductase pathway. Since this pathway is mainly responsible for the osteoclastic bone destruction, [ 68 Ga]BPAMD may be superior in osteoclastic lesions.Finally, [ 68 Ga]BPAMD seems to be an ideal PET/CT tracer to plan and monitor bisphosphonate therapy in several bone disorders like osteoporosis, osteitis deformans, bone metastases, multiple myeloma, osteogenesis imperfecta, etc. and also to monitor radionuclide therapy for palliation of bone pain.Acknowledgments Support by the EC through COST actions D38 and BM0607 is gratefully acknowledged.