This article reviews the major considerations involved in optimizing positron emission tomography-computed tomographic (PET-CT) workflows including patient management and specific acquisition, processing, and archiving procedures. Due to the dual modality nature of PET-CT and the needs of the patients typically undergoing these examinations, there is a high level of patient contact and interaction with the technologists and ancillary personnel. Each PET-CT scan itself generates a considerable volume of raw image data which must be reconstructed, and the reconstructed images distributed and archived without impeding overall workflow. PET-CT facility design and layout, the procedures for sequencing patients through each phase of the exam, and adequate staffing are important considerations for an efficient and high-quality service.