The attenuation coefficient slope (ACS) has the potential to be used for tissue characterization and as a diagnostic ultrasound tool, hence complementing B-mode images. The ACS can be valuable for the estimation of other ultrasound parameters such as the backscatter coefficient. There is a well-known tradeoff between the precision of the estimated ACS values and the data block size used in the spectral-based techniques such as the spectral-log difference (SLD). This tradeoff limits the practical usefulness of the spectral-based attenuation imaging techniques. In this paper, the regularized SLD (RSLD) technique is presented in detail, and evaluated with simulations and experiments with physical phantoms, ex vivo and in vivo. The RSLD technique allowed decreasing estimation variance when using small data block sizes, i.e., fivefold reduction in the standard deviation of percentage error when using data block sizes larger than and more than a tenfold reduction when using data blocks. The precision improvement was obtained without sacrificing estimation accuracy (i.e., estimation bias improved in 70% of the cases by 10% of the ground truth-value on average while degraded in 30% of the cases by 3% of the ground truth-value on average). The improvements in precision allowed for better differentiation of inclusions especially when using small data blocks (i.e., smaller than ) where the contrast-to-noise ratio improved by an order of magnitude on average. The results suggest that the RSLD allows for the reconstruction of attenuation coefficient images with an improved tradeoff between spatial resolution and estimation precision.