Artifacts due to attenuation can complicate the interpretation of SPECT cardiac perfusion images, especially when the attenuated region corresponds to that of a coronary vascular distribution. Since methods of correction are limited, some patients undergo coronary angiography unnecessarily. Acquisition using a three-detector camera provides more data that can serve to minimize the effects of localized attenuation if incorporated into the final reconstruction set. In this article, a practical approach for interpreting SPECT cardiac perfusion images is outlined, demonstrating with an illustrative case how this approach can be clinically helpful.