Nuclear medicine is a rapidly evolving multidisciplinary research field that has been intensively investigated in the past decades. The successful clinical application of various metal‐based radiopharmaceuticals for cancer imaging and therapy is based on the modular assembly of the drug complex through the popular bifunctional chelate (BFC) strategy. In targeted radionuclide therapy (TRT), potent radiation is selectively delivered to the cancer cells using radiopharmaceuticals that incorporate therapeutic radiometals which emit
α
‐particles,
β
−
‐particles, or Meitner–Auger electrons (MAEs). Radiotheranostics is an emerging concept that connects nuclear imaging (via positron emission tomography (PET) or single‐photon emission computed tomography (SPECT)) and therapy for personalized cancer diagnosis and treatment. This article outlines the fundamentals of radiopharmaceutical design and radiotheranostics and presents a general description of the therapeutic emissions accompanied by literature examples of the most promising radionuclides;
212
Pb,
213
Bi,
225
Ac,
227
Th, and
149
Tb for
α
therapy;
47
Sc,
67
Cu,
77
As, and
161
Tb for
β
−
therapy; and
119
Sb,
135
La, and
197m/g
Hg for MAE therapy. A comparison of the currently used or proposed theranostic pairs of each radiometal is presented.