The aim of the study was to evaluate the performance of multislice computed tomography (MSCT) for the detection and semiquantitative analysis of healed myocardial infarct in comparison to single-photon emission computed tomography (SPECT). Recently, MSCT was shown to allow detection of myocardial infarct by the presence of hypoenhanced areas. However, direct comparisons to other imaging modalities for infarct imaging were scarce. In 69 patients with healed myocardial infarct (>3 months), the presence of myocardial infarct and infarct score was assessed using SPECT and MSCT. In addition, regional and global left ventricular function was assessed using MSCT. In 62 of 69 patients (90%), a perfusion defect was detected using gated SPECT at rest. Using MSCT in these 62 patients (100%), hypoenhanced areas reflecting infarct were shown. In 3 of 7 patients (43%) without perfusion defects who underwent gated SPECT, MSCT identified regions of infarct. The infarct score on MSCT related well to the SPECT infarct score (12 +/- 10% vs 16 +/- 13%; r = 0.93, p <0.0001). In addition, good (inverse) correlations were shown for infarct score using MSCT and parameters of left ventricular function. In conclusion, healed myocardial infarct can be detected accurately using MSCT, with good correlation with SPECT.