Acoustic properties of biological tissues usually vary inhomogeneously in space. Tissues with different chemical composition often have different acoustic properties. The assumption of acoustic homogeneity may lead to blurred details, misalignment of targets and artifacts in the reconstructed photoacoustic tomography (PAT) images. This paper summarizes the main solutions to PAT imaging of acoustically heterogeneous tissues, including the variable sound speed and acoustic attenuation. The advantages and limits of the methods are discussed and the possible future development is prospected.