Coronary artery disease (CAD) is a major cause of mortality and morbidity and its management consumes a large proportion of national healthcare budgets. It has been estimated that approximately twenty diseases account for over 80% of all the deaths in the world. Specifically, atherosclerosis which occurs in the coronary arteries as the underlying defect responsible for CAD accounts for nearly half of these deaths. Although CAD treatment protocols are improving, its prevalence has increased. New imaging technologies have added to the immediate costs of investigation but they also have the potential to reduce overall costs, by virtue of their greater diagnostic and prognostic accuracy. This allows a more informed selection of therapy, which in turn can lead to a better clinical outcome. Myocardial perfusion scintigraphy (MPS) was developed in the 1970s and has been used increasingly in clinical cardiology since the 1980s. Technical developments that have fuelled this recent increase are single-photon emission tomographic computed imaging (SPECT), pharmacological stress and ECG-gated imaging.