In 75 patients 24-hour ecg monitoring value was compared with exercise test in diagnostics of postinfarction silent ischemia. Results compatibility of both comparing examinations was 79% with regard to only painless ischemia (p less than 0.001) and 91% to both estimated painless or painful episodes (p less than 0.001). Painless ischemia was observed during ecg Holter monitoring and exercise test respectively in 39% and 35% of examined patients (NS) and/or with the angina respectively in 44% and 53% (p less than 0.01). 24-hour ecg monitoring and exercise test are of a comparable value in diagnosis of postinfarction silent ischemia, whereas in diagnostics of jointly estimated painless or painful ischemia the exercise test is a more sensitive examination than ecg Holter monitoring.