By raising the lower threshold of the Tc-99m energy window, rejection of scattered photons can be made more efficient. Unfortunately, with most gamma cameras significant nonuniformities are produced when the window is changed to an asymmetric setting. Recently introduced designs with gain stabilization of the photomultiplier tubes and improved energy correction maintain field uniformity even for an asymmetric window. To assess the impact of an asymmetric energy window on clinical images, 33 Tc-99m-MDP scintigrams of the lumbar spine were taken with symmetrical (126-154 keV) and asymmetric windows (135-154 keV). Bone:soft tissue ratios improved with the asymmetric window, and the resulting images were preferred by the physicians questioned.