Thank you for asking. The tablet is a professional input device and as such, you can use the tablet for navigation or anything that you would normally do with a mouse. So, depending on the support that an application has with Pen tablets in general lines, you may or not be able to take advantage of aspects such as Pen Pressure, Tilt, etc. That said, although Paint Tool SAI is an open source app and not one we use for testing, we have seen many users using this app without problems. Hope that makes sense. Best