We describe the efficient algebraic reconstruction (EAR) method, which applies to cone-beam tomographic reconstruction problems with a circular symmetry. Three independant steps/stages are presented, which use two symmetries and a factorization of the point spread functions (PSFs), each reducing computing times and eventually storage in memory or hard drive. In the case of pinhole single photon emission computed tomography (SPECT), we show how the EAR method can incorporate most of the physical and geometrical effects which change the PSF compared to the Dirac function assumed in analytical methods, thus showing improvements on reconstructed images. We also compare results obtained by the EAR method with a cubic grid implementation of an algebraic method and modeling of the PSF and we show that there is no significant loss of quality, despite the use of a noncubic grid for voxels in the EAR method. Data from a phantom, reconstructed with the EAR method, demonstrate 1.08-mm spatial tomographic resolution despite the use of a 1.5-mm pinhole SPECT device and several applications in rat and mouse imaging are shown. Finally, we discuss the conditions of application of the method when symmetries are broken, by considering the different parameters of the calibration and nonsymmetric physical effects such as attenuation.