Stress echocardiography is frequently used for the diagnosis of coronary artery disease. Its diagnostic accuracy is strongly influenced by many variables including patient selection, type of stress procedure utilized, stress protocol, echocardiographic imaging modality, digital reviewing technology and expertise in performing and interpreting the examinations. All these must be taken into consideration when evaluating and comparing different studies presented in the literature, as well as in optimal organization (accurate selection of the appropriate stress modality and protocol execution, optimal use of technology, appropriate training of medical and non-medical personnel) of the laboratory involved in stress echocardiography.