V/P(SPECT) has the potential to become a first hand tool for diagnosis of pulmonary embolism based on standardized technology and new holistic interpretation criteria. Pretest probability helps clinicians choose the most appropriate objective test for diagnosis or exclusion of PE. Interpretation should also take into account all ventilation and perfusion patterns allowing diagnosis of other cardiopulmonary diseases than PE. In such contexts, V/P(SPECT) has excellent sensitivity and specificity. Nondiagnostic reports are ≤3%. V/P(SPECT) has no contraindication; it is noninvasive and has very low radiation exposure. Moreover, acquisition time for V/P(SPECT) is only 20 minutes. It allows quantification of PE extension which has an impact on individual treatment. It is uniquely useful for followup and research.