In the past, the major medical application of bismuth consisted of the treatment of gastric ulcers by ingestion of large quantities of bismuth citrate. More recently, the resurgence of interest for bismuth medical applications has been more oriented towards possible applications in radiotherapy, and particularly in alpha-radioimmunotherapy (Figure 9.1) [1]. As this specific application will be reviewed exhaustively in Chapter 13 of this book, we will only discuss the design, synthesis and coordination properties of bismuth porphyrin complexes in this chapter, assuming that the goals and limits of this peculiar application are known. However, we should keep in mind that both alpha-emitter isotopes of bismuth-212 and 213 exhibit a very short half life of 60 and 45 min respectively, as this radiochemical property directly implies fast kinetics formation of complexes. Even if this potential application is far from being achieved, this very basic requirement will guide the research for new bismuth porphyrins.From the coordination point of view, porphyrins are known to coordinate most of the metallic and pseudometallic elements, and metalloporphyrins with over 80 different central