Metaiodobenzylguanidine-iode 123 (123I-MIBG) myocardial scintigraphy is one of only the few methods available for the objective evaluation of cardiac sympathetic function at the clinical level. Disorders of cardiac sympathetic function play an important role in a variety of heart diseases and particularly arrhythmic disease. MIBG abnormalities have been described in various arrhythmic diseases. Their signification and their prognostic value are still not clear. This article focuses on reviewing the characteristics of 123I-MIBG myocardial scintigraphy in different arrhythmic diseases.