Myocardial perfusion imaging using positron emission tomography (PET) has several advantages over single photon emissioncomputed tomography (SPECT). The recent advances in SPECT technology have shown promise, but there is still a large needfor PET in the clinical management of coronary artery disease (CAD). Especially, absolute quantification of myocardial bloodflow (MBF) using PET is extremely important. In spite of considerable advances in the diagnosis of CAD, novel PET radiopharmaceuticalsremain necessary for the diagnosis of CAD because clinical use of current cardiac radiotracers is limited by theirphysical characteristics, such as decay mode, emission energy, and half-life. Thus, the use of a radioisotope that has propercharacteristics and a proper half-life to develop myocardial perfusion agents could overcome these limitations. In this review, thecurrent state of cardiac PET and a general overview of novel 18F or 68Ga-labeled radiotracers, including their radiosynthesis,in vivo characterization, and evaluation, are provided. The future perspectives are discussed in terms of their potential usefulnessbased on new image analysis methods and hybrid imaging.