The role of stress echocardiography (SE) as a valid and safe noninvasive method for detecting coronary artery disease and viable myocardium has been documented for more than three decades. Stress echocardiography also has an established role in the evaluation of a broad spectrum of clinical conditions, including systolic and diastolic heart failure, valvular heart disease, congenital heart disease, pulmonary hypertension, and heart transplantation. Stress echocardiography is performed with exercise, administration of a pharmacologic agent such as dobutamine or vasodilator, even mental stress, and pacing. It is important to know different methods and be flexible in choosing the appropriate test for each individual. The exercise protocol covers a treadmill exercise examination and upright or supine bicycle test with echocardiographic images. In this chapter, we will discuss the concept behind the SE, methods, interpretation, and role of SE in ischemic and nonischemic heart diseases.