The purpose of this study was to investigate the importance of 2D versus 3D compensation methods in SPECT. The compensation methods included in the study addressed two important degrading factors, namely attenuating and collimator-detector response in SPET. They can be divided into two general categories. The conventional methods are based on the filtered backprojection algorithm, the Chang algorithm for attenuation compensation and the Metz filter for detector response compensation. These methods, which were computationally efficient, could only achieve approximate compensation due to the assumptions made. The quantitative compensation methods provide accurate compensation by modelling the degrading effects at the expense of large computational requirements. Both types of compensation methods were implemented in 2D and 3D reconstructions. The 2D and 3D reconstruction/compensation methods were evaluated using data from simulation of brain and heart, and patient thallium SPECT studies. Our results demonstrate the importance of compensation methods in improving the quality and quantitative accuracy of SPECT images and the relative effectiveness of the different 2D and 3D reconstruction/compensation methods. We concluded that 3D implementation of the quantitative compensation methods provides the best SPECT image in terms of quantitative accuracy, spatial resolution, and noise at a cost of high computational requirements.