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A 52-year-old woman diagnosed with mycosis fungoides was referred for 18F-FDG PET/CT before treatment for the evaluation of disease severity. The patient also underwent 68Ga-pentixafor PET/CT for further evaluation. FDG uptake was observed in cervical, axillary, and pelvic lymph nodes and multiple widespread skin lesions throughout the body, suggestive of extensive involvement of mycosis fungoides. All lesions were visually identifiable with high target-to-background ratio on 68Ga-pentixafor PET/CT which demonstrated marked CXCR4 expression in all lesions that were detected using 18F-FDG PET/CT.