We studied the accuracy of left ventricular (LV) volumes and ejection fraction (EF) derived from ECG gated 99mTc-sestamibi myocardial perfusion SPECT (G-SPECT) and the software for automatic data analysis (QGS program described by Germano G et al.). G-SPECT was performed in 29 patients with various cardiac diseases. LV end-diastolic and end-systolic volumes (LVEDV and LVESV), and LVEF determined by QGS program were compared to those by Simpson method in biplane left ventriculography (LVG). Interobserver reproducibility in measuring the G-SPECT parameters was excellent (LVEDV: r = 0.99, LVESV: r = 0.99, LVEF: r = 0.97). There was a good correlation between the values obtained from G-SPECT and LVG (LVEDV: r = 0.92, LVESV: r = 0.94, LVEF: r = 0.85), but G-SPECT tended to underestimate LVEDV and LVEF. In 17 patients with moderate to severe myocardial perfusion defects selected from the subjects, the correlation was maintained fairly high (LVEDV: r = 0.90, LVESV: r = 0.92, LVEF: r = 0.77). In conclusion, QGS program provides high accuracy and reproducibility in determining LV volumes and LVEF from G-SPECT.