Stress echocardiography is a relatively new technique that combines cardiovascular stress with echocardiographic imaging for the diagnosis of coronary artery disease. It is based on the hypothesis that stress-induced ischemia will result in regional wall motion abnormalities that can be detected by two-dimensional echocardiography or abnormalities of global function that can be detected with Doppler ultrasound. Its accuracy for detecting coronary artery disease is high enough to allow for clinical use. In such a role it has added value to the analysis of the routine electrocardiogram and symptoms during exercise. In the patient unable to exercise, pharmacological stress with the use of dobutamine or dipyridamole are realistic alternatives. In addition to the diagnosis of coronary disease, stress echocardiography can be used to demonstrate recovery of function after interventions and to assess prognosis after myocardial infarction.