In high radiation fields, gamma cameras suffer from pulse pile-up, resulting in poor energy resolution, count losses, and image distortion. To overcome this problem, various methods have been introduced to reduce the size of the aperture or pixel, reject the pile-up events, and correct the pile-up events, but these technologies have limitations in terms of mechanical design and real-time processing. The purpose of this study is to develop a real-time gamma camera to evaluate the radioactive contamination in high radiation fields. The gamma camera is composed of a pinhole collimator, NaI(Tl) scintillator, position sensitive photomultiplier (PSPMT), signal processing board, and data acquisition (DAQ). The pulse pile-up is corrected in real-time with a field programmable gate array (FPGA) using the start time correction (STC) method. The STC method corrects the amplitude of the pile-up event by correcting the time at the start point of the pile-up event. The performance of the gamma camera was evaluated using a high dose rate 137Cs source. For pulse pile-up ratios (PPRs) of 0.45 and 0.30, the energy resolution improved by 61.5 and 20.3%, respectively. In addition, the image artifacts in the 137Cs radioisotope image due to pile-up were reduced.