Abstract. Parallel and converging hole collimators are most frequently used in nuclear medicine. Less common is the use of rotating slat collimators for Single Photon Emission Computed Tomography (SPECT). The higher photon collection efficiency, inherent to the geometry of rotating slat collimators results in much lower noise in the data. However, plane integrals contain spatial information in only one direction, whereas line integrals provide two-dimensional information. It is not a trivial question whether the initial gain in efficiency will compensate for the lower information content in the plane integrals. Therefore, a comparison of the performance of parallel hole and rotating slat collimation is needed. This study compares SPECT with rotating slat and parallel hole collimation in combination with MLEM reconstruction with accurate system modeling and correction for scatter and attenuation. A contrast-to-noise study revealed an improvement of a factor 2 to 3 for hot lesions and more than a factor of 4 for cold lesion. Furthermore, a clinically relevant case of heart lesion detection is simulated for rotating slat and parallel hole collimators. In this case, rotating slat collimators outperform the traditional parallel hole collimators. We conclude that rotating slat collimators are a valuable alternative for parallel hole collimators.