Dobutamine stress echocardiography has been increasingly used for the preoperative assessment of patients who undergo major vascular surgery. The safety of this modality has been well documented in various patient subgroups, including patients with aneurysms of the aorta. No previous reports, however, have addressed the safety of this form of stress testing in patients with unruptured intracranial aneurysms. After reviewing the experience of 2 institutions, we identified 40 patients who underwent dobutamine stress echocardiography while harboring at least 1 unruptured intracranial aneurysm, and found no evidence of aneurysm instability in relation to the dobutamine infusion. Although vasodilator stress modalities should intuitively be the non-exercise stress technique of choice in these patients, stress echocardiography with the use of dobutamine appears to be safe and represents an acceptable option when used for diagnostic purposes or preoperative risk stratification in this patient population.