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A 39-year-old woman with papillary thyroid cancer underwent 131 I therapy after thyroidectomy. Posttherapeutic 131 I whole-body scan accidentally showed symmetric “hot spots” in the pelvic region beyond known bone metastases. SPECT/CT was immediately added and revealed metal artifacts with 131 I accumulation in the nearby uterus. Further inquiry discovered that she underwent tubal ligation 19 years ago. Our case demonstrates that 131 I accumulation can occur at the site of oviducts many years after tubal ligation, which should be distinguished from 131 I-avid metastases.