Purpose of Review As machine learning-based artificial intelligence (AI) continues to revolutionize the way in which we analyze data, the field of nuclear cardiology provides fertile ground for the implementation of these complex analytics. This review summarizes and discusses the principles regarding nuclear cardiology techniques and AI, and the current evidence regarding its performance and contribution to the improvement of risk prediction in cardiovascular disease. Recent Findings and Summary There is a growing body of evidence on the experimentation with and implementation of machine learning-based AI on nuclear cardiology studies both concerning SPECT and PET technology for the improvement of risk-of-disease (classification of disease) and risk-of-events (prediction of adverse events) estimations. These publications still report objective divergence in methods either utilizing statistical machine learning approaches or deep learning with varying architectures, dataset sizes, and performance. Recent efforts have been placed into bringing standardization and quality to the experimentation and application of machine learning-based AI in cardiovascular imaging to generate standards in data harmonization and analysis through AI. Machine learning-based AI offers the possibility to improve risk evaluation in cardiovascular disease through its implementation on cardiac nuclear studies. Graphical Abstract AI in improving risk evaluation in nuclear cardiology. * Based on the 2019 ESC guidelines

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