As a non-invasive examination measure, radionuclide myocardial perfusion imaging (MPI) is of its own uniqueness in functional imaging rather than simply anatomic imaging. It can objectively and accurately assess pathophysiological changes caused by coronary artery lesions, including myocardial perfusion, myocardial cells function and ventricular dysfunction. In this paper, we reviewed the application of radionuclide MPI in the diagnosis, treatment decisions, efficacy prediction and prognosis judgment of coronary heart disease.