State-of-the-art instrumentation and computer methods in myocardial perfusion SPECT imaging are now either available or soon to be available to clinicians worldwide. Advancements in instrumentation such as multiple detector systems and attenuation correction techniques have resulted in myocardial perfusion images with higher spatial and contrast resolution, more counts, and less degradation due to radiation absorption and scatter Advancements in computer methods have evolved in key areas such as: multiple gated SPECT acquisition, automation, measurement of functional parameters, three-dimensional displays, image fusion and the use of artificial intelligence in decision support systems. These advancements in computers methods applied to higher quality images from the instrumentation advancements have resulted in tools which allow the clinicians to make a more comprehensive and accurate assessment of their patients' myocardial status. These advancements continue to strengthen the already strong role of myocardial perfusion SPECT imaging in the diagnosis and prognosis of patients with coronary artery disease.