Imaging, along with clincial examiniation, plays a key role in determining the presence and extent of bisphosphonate-related osteonecrosis of the jaw (BRONJ). In this case, cone-beam computerized tomography (CBCT) was used to detect a large sequestrum and hyperstotic bone, leading to a diagnosis of bisphosphonate-related osteonecrosis of the jaw in a patient with a history of oral bisphosphonate use for treatment of osteoporosis. The radiographic features of this case of BRONJ are discussed. Quintessence Int 2009;40:163–165. Key words: BRONJ, CBCT, extractions, marginal periodontitis, radiographs, sequestrum