Introduction: Hydrogen sulfide (H2S) defined as the third gasotransmitter after nitric oxide (NO) and carbon monoxide (CO) is an important mediator of various physiological functions. Although various H2S-imaging techniques using fluorescence and luminescence have been developed, only one radionuclide imaging using 64Cu-labeled cyclen complex was reported. Thus, we tried to develop 99mTc-labeled H2S imaging agents. Methods: Various α-hydroxy acids such as glycolate, L-lactate, D-lactate, D-gluconate, D-glucoheptonate, D-glucuronate, D-glucarate, and citrate were labeled with 99mTc in the presence of stannous chloride. The labeled compounds were incubated with 0.2 mM of NaHS, and reactive sulfur species and then analyzed by ITLC/normal saline to detect the formation of insoluble complex. Matrigels containing various concentrations of NaHS were xenografted on the shoulder of normal mice, and an imaging study was performed after intravenous injection of [99mTc]Tc-gluconate. We also obtained autoradiography image of a rat brain with a temporary brain ischemia after intravenous injection of [99mTc]Tc-gluconate. Results: [99mTc]Tc-gluconate showed the highest formation of insoluble complex (87.8 ± 3.6%) after incubation with 0.2 mM NaHS. The other reactive species such as glutathione, cysteine, sulfite, sulfate, thiosulfate, and NO did not form insoluble complex representing the reaction being specific to H2S. The Matrigel containing 2 μmol NaHS showed uptake of [99mTc]Tc-gluconate, which proved the feasibility as the specific H2S imaging agent in vivo. Temporary ischemic lesion of rat brain showed high radioactivity accumulation representing the feasibility as endogenous H2S imaging agents. Conclusion: We proved that 99mTc-labeled α-hydroxy acid especially [99mTc]Tc-gluconate is a novel endogenous H2S imaging agent, which might contribute to study and diagnosis of various diseases related with inflammation and hypoxia.