The diagnostic workup of primary lymphedema includes lymphoscintigraphy, a diagnostic test that provides objective data derived from the characteristics of the lymphatic flow and the lymphatic nodes. Several empirical scoring systems have been proposed with the aim of harmonizing the procedure. Here we comment the latest one, reflecting on the relevance of these tools to make possible multicenter research, based on intraobserver and interobserver reliability with the aim to, in the long run, improve patient outcomes.