In this article, we describe recent developments in the design of both single-photon emission computed tomography (SPECT) and positron emission tomography (PET) instrumentation that have led to the current range of superior performance instruments. The adoption of solid-state technology for either complete detectors [e.g., cadmium zinc telluride (CZT)] or read-out systems that replace photomultiplier tubes [avalanche photodiodes (APD) or silicon photomultipliers (SiPM)] provide the advantage of compact technology, enabling flexible system design. In SPECT, CZT is well suited to multi-radionuclide and kinetic studies. For PET, SiPM technology provides MR compatibility and superior time-of-flight resolution, resulting in improved signal-to-noise ratio. Similar SiPM technology has also been used in the construction of the first SPECT insert for clinical brain SPECT/MRI.