The multi-pixel photon counter (MPPC) is a promising light sensor for various applications, not only in physics experiments but also in nuclear medicine, industry, and even high-energy astrophysics. In this paper, we present the current status and most recent progress of the MPPC-based scintillation detectors, such as (1) a high-precision X-ray and gamma-ray spectral image sensor, (2) next-generation PET detectors with MRI, TOF, and DOI measurement capabilities, and (3) a compact gamma camera for environmental radiation surveys. We first present a new method of fabricating a Ce:GAGG scintillator plate (1 or 2mm thick) with ultra-fine resolution (0.2mm/pixel), cut using a dicing saw to create 50μm wide micro-grooves. When the plate is optically coupled with a large-area MPPC array, excellent spatial resolution of 0.48mm (FWHM) and energy resolution of 14% (FWHM) are obtained for 122keV gamma rays. Hence, the detector can act as a convenient “multi-color” imaging device that can potentially be used for future SPECT and photon-counting CT. We then show a prototype system for a high-resolution MPPC-based PET scanner that can realize ≃1mm (FWHM) spatial resolution, even under a strong magnetic field of 4.7T. We develop a front-end ASIC intended for future TOF-PET scanner with a 16-channel readout that achieves a coincidence time resolution of 489ps (FWHM). A novel design for a module with DOI-measurement capability for gamma rays is also presented by measuring the pulse height ratio of double-sided MPPCs coupled at both ends of scintillation crystal block. Finally, we present the concept of a two-plane Compton camera consisting of Ce:GAGG scintillator arrays coupled with thin MPPC arrays. As a result of the thin and compact features of the MPPC device, the camera not only achieves a small size (14×14×15cm3) and light weight (1.9kg) but also excellent sensitivity, compared to the conventional PMT-based pinhole camera used in Fukushima. Finally, we briefly describe a new product recently developed in conjunction with Hamamatsu Photonics K.K. that offers improved sensitivity and angular resolution of Δθ~8° (FWHM) at 662keV, by incorporating DOI-segmented scintillator arrays.