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Tc-99m is used in over 80% of all nuclear medicine scans. The Canadian NRU and French OSIRIS nuclear reactors are expected to stop producing medical radioisotopes in 2016. As there are only a handful of reactors currently producing this isotope there are significant risks of supply disruption in the upcoming years. This presentation will describe the global supply chain used in the production of Tc-99m. The latest supply and demand forecast will be examined as will the status of alternative sources of supply in development. The last portion of the presentation will review the various collaborative initiatives underway in Canada and internationally to monitor and address the situation.