Two-dimensional echocardiographic monitoring during catecholamine infusion has shown promise as a safe and accurate method for detection of coronary artery disease. The clinical application of catecholamine stress echocardiography has been facilitated by the development of digital image processing techniques. The sensitivity of this method of stress testing has been improved by drug infusion protocols that are designed to maximize myocardial stress. Recent investigations have demonstrated the value of dobutamine stress echocardiography for detection of multivessel disease following myocardial infarction and for assessment of cardiac risk before noncardiac surgery. Evaluation of changes in wall motion and thickening that occur during low dose dobutamine infusion may enable detection of viable myocardium after thrombolytic treatment of acute myocardial infarction. Compared to alternative noninvasive diagnostic methods, catecholamine stress echocardiography permits continuous acquisition of high-quality information on regional and global systolic function. This and other advantages have prompted the search for broader applications of this technique.