Purpose The long-term trend of extrinsic uniformity by type of gamma camera was analyzed, and the factors affecting uniformity were investigated. Based on this, the purpose was to predict the life of the gamma camera, pay attention to factors that affect uniformity, and obtain better quality images. Materials and methods Four of the gamma cameras in operation at a senior general hospital in Seoul were selected and the trend of extrinsic uniformity from the first operation date to the present was analyzed. In order to minimize various factors affecting uniformity, a detailed analysis was conducted by calculating the monthly and annual average of the uniformity values. Results Two Symbia E gamma cameras from SIEMENS, one Symbia Evo Excel gamma camera, and one Symbia Intevo16 gamma camera were selected and analyzed. The uniformity of Symbia E1 (2012 warehousing) changed unevenly, and the uniformity of Symbia E2 (2014 warehousing) changed according to the replacement cycle of 57Co sheet sources. The uniformity of Symbia Evo Excel (received in 2017) and Symbia Intevo 16 (received in 2017) was constant compared to Symbia E. Conclusion The extrinsic uniformity of the gamma camera gradually increased over time. However, there was a difference in uniformity for each type of gamma camera, and there was a change in uniformity in which the cause could not be accurately identified. In order to improve the quality of the image, it is necessary to periodically check changes in uniformity and minimize factors that affect uniformity.