Introduction: Absolute pitch (AP), or more commonly known as “perfect pitch”, is the rare ability to label pitches without needing a reference note. While its mechanisms are still unknown, there are many different theories regarding how and why some individuals develop AP, while others do not. Some argue that the ability is genetically inherited, while others argue that AP is a skill preferentially learned at a young age, with links to musical training and tonal language learning. This review investigates the possible factors that lead to AP development, as well as possible neurobiological underpinnings of the ability. Methods: A literature search was conducted using scientific databases to reveal studies examining the impact of genetic, learning, musical training, language, and neuroimaging on AP development. Empirical studies written in English were examined for this review, with emphasis on how AP is differentially reflected in developmental and neuroimaging perspectives. Results: Genetics, learning, musical training, and language all play a role in AP development, with some having a greater impact than others. Young children are easily taught absolute pitch using training programs, while it is much more difficult in adults. Furthermore, the apparent critical period for AP development closely resembles the time frame of the critical period of language acquisition. The phenomenon of AP is apparent through localized brain function, which differs from non-AP individuals. Discussion: Genetic, musical training, and language all play an interconnected role in the development of AP. However, neuroimaging research is vastly separate, not integrating findings from other areas. Overall, looking at the various factors combined allows for a more complete understanding of AP. Conclusion: Currently, there is a lack of research linking genetic and environmental influences on AP development with specific brain structure and function, which future neuroimaging research should seek to do. Understanding AP development benefits musicians and furthers an understanding of human perception of the auditory environment.