A 48-year-old male patient of papillary thyroid cancer, status post-thyroidectomy and node dissection, was referred to 131I scan prior to radioiodine treatment. The images showed 1 additional focus of 131I uptake in the right upper neck outside of the thyroid bed. SPECT/CT demonstrated 2 separate foci of radioiodine uptake in the right parotid gland, instead of neck lymph nodes. Diagnostic CT showed 2 corresponding soft tissue nodules in the right parotid gland which were confirmed latter by fine-needle aspiration to be Warthin tumors. This case illustrates a pivotal role of SPECT/CT in differential diagnosis of abnormal neck uptake on 131I thyroid cancer scan.