We present a rare case of extracardiac activity in right hemitorax secondary to the Chilaiditi sign and diaphragmatic paralysis due to right hemiplegia identified incidentally during myocardial perfusion scintigraphy. A 77-year-old man with right hemiplegia suspected of having ischemic heart disease, was admitted for myocardial perfusion scintigraphy studies. On raw data images, intense bowel uptake in the right hemithorax was visualized. Chest radiography and CT images of the patient were evaluated and Chilaiditi sign was found. This sign is a relatively rare condition with an incidence ranging between 0.025% and 0.28%, considered as a normal variant.