Background: PET scanners using silicon photomultipliers with digital readout (SiPM PET) have an improved temporal and spatial resolution compared to PET scanners using conventional photomultiplier tubes (PMT PET). However, the effect on image quality and visibility of perfusion defects in myocardial perfusion imaging (MPI) is unknown. Our aim was to determine the value of a SiPM PET scanner in MPI. Methods: We prospectively included 30 patients who underwent rest and regadenoson-induced stress Rubidium-82 (Rb-82) MPI on the D690 PMT PET (GE Healthcare) and within three weeks on the Vereos SiPM PET (Philips Healthcare). Two expert readers scored the image quality and assessed the existence of possible defects. In addition, interpreter’s confidence, myocardial blood flow (MBF) and myocardial flow reserve (MFR) values were compared. Results: Image quality improved (p=0.03) using the Vereos as compared to the D690. Image quality of the Vereos and the D690 was graded fair in 20% and 10%, good in 60% and 50%, and excellent in 20% and 40%, respectively. Defect interpretation and interpreter’s confidence did not differ between the D690 and the Vereos (p>0.50). There were no significant differences in rest MBF (p≥0.29), stress MBF (p≥0.11) and MFR (p≥0.51). Conclusion: SiPM PET provides an improved image quality in comparison to PMT PET. Defect interpretation, interpreter’s confidence and absolute blood flow measurements were comparable between both systems. SiPM PET is therefore a reliable technique for MPI using Rb-82.