A three-dimensional position-sensitive radiation detector is provided which has a three-dimensional array of photodetectors disposed on the surface of a scintillator block and which is capable of three-dimensionally identifying the position of light emission at which radiation has been detected within the detector. The three-dimensional position-sensitive radiation detector includes: a scintillator block including a central portion which restricts the direction of diffusion of light so as to direct the light in three axial directions and which has an optically discontinuous region, and an outer portion which is disposed on the outside of the central portion and which does not restrict the direction of diffusion of light; and photodetectors disposed on at least two outer circumferential surfaces of the scintillator block. The detector identifies three-dimensionally the position of light emission, thereby preventing deterioration in position discrimination performance even when inner scintillator elements are smaller than the photodetectors.