Parkinsonism is a neurological syndrome characterized by tremor, bradykinesia, rigidity, and postural instability. The underlying causes of parkinsonism are numerous. It is of paramount importance to make clean distinction among these diseases. However, the differential diagnosis of parkinsonism is challenging. Simultaneous dual-radionuclide brain SPECT allows us to assess both blood perfusion and dopamine transporter function under the identical physiological conditions. This approach has been proven to improve the differential diagnosis of parkinsonism. The simultaneous (99m)Tc-ECD/(123)I-FP-CIT brain SPECT protocols, which are used for the differential diagnosis of idiopathic Parkinson's disease and multiple system atrophy as well as corticobasal degeneration and progressive supranuclear palsy, are presented.