The emergence of hybrid imaging, combining anatomical computed tomography (CT) and functional scintigraphic imaging has increased the armoury of techniques available to image disease. Single photon emission computed tomography/CT (SPECT/CT) is a dual modality technique which increases the sensitivity and specificity of existing radionuclide imaging and helps characterise equivocal lesions detected by other imaging methods. In addition to the many established clinical applications for SPECT/CT, there are new clinical uses emerging in a spectrum of benign and malignant diseases. In this article, we will discuss the established and emerging uses of hybrid SPECT/CT and illustrate the incremental value of the technique in a variety of clinical applications.