The demands on detectors for particle detection as well as for medical and astronomical X-ray imaging are continuously pushing the development of novel pixel detectors. The state of the art in pixel detector technology to date are hybrid pixel detectors in which sensor and read-out integrated circuits are processed on different substrates and connected via high density interconnect structures. While these detectors are technologically mastered such that large scale particle detectors can be and are being built, the demands for improved performance for the next generation particle detectors ask for the development of monolithic or semi-monolithic approaches. Given the fact that the demands for medical imaging are different in some key aspects, developments for these applications, which started as particle physics spin-off, are becomming rather independent. New approaches are leading to novel signal processing concepts and interconnect technologies to satisfy the need for very high dynamic range and large area detectors. The present state in hybrid and (semi-)monolithic pixel detector development and their different approaches for particle physics and imaging application is reviewed.