Pulmonary tromboembolism is a potentially fatal condition for which treatment is highly effective. The diagnosis of pulmonary embolism can be challenging and often requires diagnostic imaging. In the evaluation of this condition for many years first chest radiographs and then ventilation perfusion scintigraphy have been the primary diagnostic tools. Later the combination of clinical assessment with the results of ventilation perfusion scans and the evaluation of the deep venous system of the lower extremities helped the clinicians in the assessment of embolus. More recently, advances in computed tomography angiography gained importance for its advantage in direct visualization of emboli. In this review focusing on ventilation and perfusion scintigraphy, recent advances in nuclear medicine technology in the diagnosis of pulmonary embolism is given.