Background: Stress echocardiography represents the combination of 2D echocardiography with a physical, pharmacological or electrical stress. The diagnostic end point for the detection of myocardial ischemia is the induction of transient worsening in regional function during stress. The presence (or absence) of inducible wall motion abnormalities specifies patients with different prognosis. This article represents an analysis and a short synthesis of recent information about stress echocardiography and its role in clinical practice for the determination of myocardial viability and the assessment of prognosis of patients with coronary artery disease. The data were structured in several aspects: the features of viable myocardium, the importance of the identification of hibernating myocardium for the management of patients with coronary artery disease and the role of stress echocardiography in this management. Dobutamine stress echocardiography is by far the most widely used method for assessing viable myocardium. This is mandatory in patients with left ventricle disfunction who may benefit from coronary revascularization. Conclusions: Stress echocardiography plays one of the main roles in management of patients with coronary artery disease, especially in the assessment of prognosis before revascularization and the long-term prognosis. The decision is based on the identification of viable myocardium that is hibernating. By far, the widest experience is available with dobutamine stress echocardiography, the preferred stressor for assessing myocardial viability.