Silicon photodetectors have been successfully employed for scintillation detection in gamma-ray spectroscopy and imaging applications. When compared to photomultiplier tubes (PMTs), silicon photodetectors are characterized by higher quantum efficiency to the scintillation light. Moreover, these devices are more compact, immune to magnetic fields and can be easily integrated in monolithic arrays of units whose size could range from few mm2 up to some cm2. New gamma-ray detection systems based on scintillators coupled to silicon photodetectors have been recently developed for astrophysics experiments as well as for imaging systems in nuclear medicine. Among silicon detectors, conventional silicon PN photodiodes (PDs), avalanche photodiodes (APDs) and silicon drift detectors (SDDs) have been used with scintillators both as single units and as monolithic arrays. In the paper, the main features of silicon photodetectors used with scintillators for gamma detection are shortly described and the more recent achievements in their development are overviewed. Finally, a comparison of the achievable performances with PDs, APDs, and SDDs is reported.