Somatostatin receptor (SSTR) imaging with PET/computed tomography (CT) is a key investigation for diagnosis, staging, restaging and evaluation of potential suitability for radionuclide therapy in patients with neuroendocrine tumors and other neoplasms. An understanding of the physiologic distribution of somatostatin receptors, patterns of nonmalignant SSTR expression as well as the technical factors that influence lesion intensity are essential for accurate reporting of SSTR PET/CT. Here we present a practical guide to SSTR PET/CT, highlighting important biological concepts and common pitfalls to assist with accurate reporting.