Single photon emission computed tomography (SPECT) is a medical imaging modality that combines conventional nuclear medicine imaging technique and methods of computed tomography (CT). From images that represent the biodistribution of the injected radiopharmaceutical in the patient, SPECT provides functional information that is unique. The first SPECT system was developed in the sixties. However, early progress of SPECT was hampered by the lack of adequate image reconstruction methods. The development of x-ray CT and image reconstruction methods in the seventies spurred a renewed interest in SPECT. In 1981, the first commercial SPECT system based on a single rotating camera was available for clinical use. Today, most modern SPECT systems consist of multiple cameras that rotate around the patients. They have better spatial resolution and higher detection efficiency as compared to the earlier single camera systems. Recently, a new generation of dual camera systems allowing for coincidence imaging of positron emitting radiopharmaceuticals has emerged in the commercial market. Additionally, new quantitative image reconstruction methods are under development. They compensate for image degrading factors including attenuation, collimator-detector blurring and scatter. Also, they result in SPECT images with improved image quality and more accurately represent the three-dimensional radioactivity distribution in the patient. Such advances in radiopharmaceuticals, instrumentation, image reconstruction, compensation methods, and clinical applications have fueled a steady growth of SPECT as an important diagnostic tool in patient management.