Objective To summarize the features of 18 F-FDG PET/CT in POEMS syndrome, and explore its role in the diagnosis and treatment of the disease. Methods The clinical data, laboratory and imaging data of 7 patients with POEMS syndrome who were clinically or pathologically confirmed by PET/CT examination in Tangdu hospital from 2021 to 2024 were retrospectively analyzed. Results Among the 7 patients, there were 2 males and 4 females, aged 51.7±11.9 years old. 18 F-FDG PET/CT imaging findings: 5 patients had different degrees of bone lesions, all of which were multiple, with a total of 273 lesions, mainly distributed in the spine, pelvis, ribs, etc. Sclerotic lesions were the most common (257/273，94.1%), mixed lesions (13/273，4.8%) and osteolytic lesions (3/273，1.1%) were less common. The SUVmax of simple sclerotic bone lesions, mixed bone lesions and osteolytic bone lesions were 2.50±1.85±0.57, 3.03±2.33 and 9.20±8.12. Most of the 5 patients with lymph node lesions were mildly enlarged. FDG uptake in lymph nodes with short diameter ≥1cm was slightly higher, and SUVmax was 2.06±0.66. There were 3 cases of liver enlargement, 4 cases of spleen enlargement and 2 case of double kidney enlargement. There were 5 cases of serous cavity effusion, of which 4 were multiple cases and 1 was single case. No abnormal FDG uptake was found. Conclusion 18 F-FDG PET/CT can evaluate the characteristics of osteopathy, lymphadenopathy, organ enlargement and polyserous effusion in POEMS syndrome, which has important clinical value in early diagnosis, biopsy location and therapeutic evaluation of the disease