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Objectives To assess the clinical significance and single-photon emission computed tomography/computed tomography (SPECT/CT) features of atraumatic costal cartilage fracture (CCF) in patients with malignant tumors. Methods This was a retrospective review of 38 tumor patients with atraumatic CCF referred to SPECT/CT, who were served as the study group (SG). The features of SPECT/CT of atraumatic CCF were assessed. Another 100 tumor patients who underwent chest SPECT/CT and did not have CCF were randomly selected as the control group (