Stress echocardiography is a combination of real-time echocardiographic imaging with conventional electrocardiographic stress testing. Stress echocardiography is arguably the most cost-effective test, as compared to nuclear imaging or coronary angiography, for diagnosis, prognosis and therapeutic decision-making in coronary artery disease (CAD). Stress echocardiography uses either exercise or pharmacological stressors depending on the patient profile and the clinical situations. Harmonic imaging and ultrasound contrast use in stress echocardiography have improved the sensitivity, specificity, accuracy and prognostic power of the test. This chapter covers the scope of the document, indications for stress echocardiography and appropriate usage criteria, fundamental principles of stress echocardiography, setting up a stress echocardiography laboratory, performance of stress echocardiography, diagnostic accuracy of stress echocardiography, role of newer modalities in stress echocardiography, clinical relevance of ischemia detection with stress echocardiography, and assessment of myocardial viability.