Stress echocardiography has emerged as an accurate, clinically important noninvasive tool for detecting the presence of ischemic heart disease. Details of patient selection, methods, analysis, and interpretation are discussed. The relative merits of peak versus post-exercise data acquisition and qualitative versus quantitative interpretation are presented. The role of stress echocardiography in clinical decision making in relation to other diagnostic modalities is also discussed. The emerging role of myocardial contrast echocardiography in assessing regional myocardial blood flow is presented briefly.