The analysis of 100 cities and towns reveals Banff and Huntly in Aberdeenshire have the highest vacancy rate with one in three shops empty - more than double the Scottish average.
Business leaders and analysts have warned that urgent action is now required to resuscitate the high street.
The examination of the health of Scotland's high streets by the Institute for Retail Studies at the University of Stirling and The Local Data Company (LDC) says one in five Scottish towns has vacancy rates of 20% or more.
The report says the 14.5% retail vacancy rate in all towns and cities in Scotland compares to 14.1% for the whole of Britain.
Around one in seven towns and cities had a rise in retail vacancies in the past year, while in 65% of cases the rate had stayed the same.
David McCorquodale, head of retail at accountancy giant KPMG, said: "This data clearly shows that Scottish high streets are polarising between the thriving and the merely surviving.
"With one in five shops lying empty in 20% of Scottish towns, it is vital we pinpoint and tackle the key issues causing these vacancies.
"There is no quick fix. In most cases it is necessary to reduce the amount of shops on the high street and bring back leisure and residential use, to reinvigorate the high street, allowing it to evolve to meet the needs of the modern consumer.
"The report and debate is an important start to help inform the future reconfiguration, and rescue, of the heartland of our local communities."
In Scotland's cities, Inverness, with the greatest number of shops as a percentage of total premises at 65%, had the highest vacancy rate at 18%. Edinburgh performed best with a 12% vacancy rate.
The report said the extent of the vacant shops indicated "slow market adaptation and the need for rethinking about our use of space".
It said the importance of retailing to towns and cities is underlined by the fact at least 50% of town centre premises are in retail use. In cities the figure rose to more than 60%.
Fifteen Scottish towns had a vacancy rate at least half that or lower than the Scottish average.
An examination of the towns suggested a strong tourist focus and a potential reliance on visitor spend in many, including North Berwick, Gretna, Callander, Inverurie, St Andrews and Linlithgow.
However, concerns were also raised that the level of retail diversity in Scottish town centres was declining, with six out of seven cities and 19 out of 29 town showing a decline in the past 12 months.
The authors believed that may be in part the result of online retailing for specialist items and the withdrawal of multiple retailers from smaller towns.
Laura McMahon of CBI Scotland said: "High streets are suffering from a lack of strategic vision, so a business plan for each town centre remains necessary - giving businesses the opportunity to work alongside local authorities to breathe new life into our town centres."
Colin Borland, Scottish head of external affairs for the Federation of Small Businesses, added: "Online shopping and out-of-town malls aren't going away, so we need to make it easier to get other sectors into these empty units."
Marc Gander, of the Consumer Action Group, said: "The Scottish population is far more fragmented than the general population and depends far more on its communities."
Professor Leigh Sparks, of the Institute for Retail Studies at the University of Stirling, added: "This report shows that, despite the concerns, retailing is still a fundamentally important and numerically and economically significant component of Scotland's cities and towns. But there is considerable variation in the significance of, and make-up of, the retail mix across Scotland's towns and cities."