Evaluation of vesico-ureteric reflux (VUR) with radionuclide imaging techniques has evolved, with the introduction of new ways to improve sensitivity in the detection of VUR. These examinations include techniques that make use of a bladder catheter (direct isotope cystogram) and techniques with no catheter (indirect radionuclide cystogram). The direct isotope cystogram (DIC) is slowly fading away, leaving more room to the radiological micturating cystogram. The indirect radionuclide cystogram (IRC) has been recently improved, with more comprehensive acquisition and processing protocols. The IRC explores bladder emptying in a physiological condition. It offers a complete evaluation of the excretory system, including renal parenchymal integrity and contribution to total renal parenchymal function, drainage and completeness/timing of bladder emptying, with the possible detection of VUR during physiological micturition. The study can also be used as a screening test for bladder function if a non-invasive urodynamic bladder contraction assessment with a flow meter is performed during bladder emptying.