Purpose $^{18}F$-fluoride bone positron emission tomography (PET) has been reported as a useful bone imaging modality. However, no clinical bone PET study had been performed previously in Korea. The authors investigated the usefulness of $^{18}F$-fluoride bone PET in Korean patients with malignant or benign bone disease. Methods Eighteen consecutive patients (eight women, ten men; mean age, $55{pm}12$ years) who had undergone $^{18}F$-fluoride bone PET for the evaluation of bone metastasis (n=13) or benign bone lesions (n=5) were included. The interpretation of bone lesions on $^{18}F$-fluoride bone PET was determined by consensus of two nuclear medicine physicians, and final results were confirmed using combination of all imaging studies and/or clinical follow-up. The analysis was performed on the basis of lesion group. Results Thirteen patients with malignant disease had 15 lesion groups, among which seven were confirmed as metastatic bone lesions and eight were confirmed as non-metastatic lesions. $^{18}F$-fluoride bone PET correctly identified six of seven metastatic lesions (sensitivity, 86%), and seven of eight nonmetastatic lesions (specificity, 88%). On the other hand, five patients with benign conditions had five bone lesion groups; four were confirmed as benign bone diseases and the other one was confirmed as not a bone lesion. $^{18}F$-fluoride bone PET showed correct results in all the five lesion groups. Conclusions $^{18}F$-fluoride bone PET showed promising potential for bone imaging in Korean patients with malignant diseases as well as with various benign bone conditions. Therefore, further studies are required on the diagnostic performance and cost-effectiveness of $^{18}F$-fluoride bone PET.