We studied six restless legs syndrome (RLS) patients with [F18]fluorodeoxyglucose (FDG) positron emission tomography (PET). We also studied four of these same patients with [F18]fluorodopa (FDOPA) PET. The patients' FDG and FDOPA PET scans were compared with those from age-matched healthy control subjects. No significant differences between the two groups were found for any regional blood flow values derived from the FDG scans or for any binding constants derived from the FDOPA scans. These results suggest that any abnormal resting brain metabolic activity or putative presynaptic dopaminergic defect in RLS is likely either to be so subtle that it is below the threshold for ready detection by PET or that it is located in an area of neural tissue inaccessible to the current scanner. No substantial defect is likely to involve the dopaminergic nigrostriatal axis.