Myocardial perfusion imaging (MPI) using nuclear cardiology techniques has been widely applied in clinical practice because of its well-documented value in the diagnosis and prognosis of coronary artery disease. Industry has developed innovative designs for dedicated cardiac SPECT cameras that constrain the entire detector area to imaging just the heart. New software that recovers image resolution and limits image noise has also been implemented. These SPECT innovations are resulting in shortened study times or reduced radiation doses to patients, promoting easier scheduling, higher patient satisfaction, and, importantly, higher image quality. This article describes these cardiocentric SPECT software and hardware innovations, which provide a strong foundation for the continued success of myocardial perfusion SPECT.