BACKGROUND: Pulmonary hypertension (PH) is a rare but progressive disorder characterized by elevated pressure in the pulmonary arteries. Early diagnosis is essential for effective treatment; however, its nonspecific symptoms often lead to delayed diagnosis. METHODS: In this retrospective cross-sectional study, a total of 648 patients who underwent myocardial perfusion scintigraphy (MPS) were analyzed. The patients were divided into two groups: those suspected of having PH and a control group without such suspicion. Ratios of right ventricular uptake to septal and lateral wall uptake on MPS were compared with pulmonary artery pressures (PAP) measured by transthoracic echocardiography. Correlation analyses focused particularly on changes following exercise. RESULTS: Among patients suspected of having PH, significant positive correlations were observed between right ventricular uptake ratios and PAPs. The p-values for rest right/septum, rest right/lateral, stress right/septum, and stress right/lateral were 0.001, 0.002, 0.001, and 0.001, respectively. This relationship was more pronounced after exercise. In contrast no significant correlation was detected in the control group. These findings indicate that increased right ventricular activity on MPS may reflect early hemodynamic changes associated with PH. CONCLUSIONS: MPS may be considered a non-invasive adjunctive modality that can provide supportive information for the early diagnosis of PH. Nevertheless, due to the retrospective design and absence of invasive confirmation, further prospective studies with larger cohorts are warranted.