Stress echocardiography has become an established tool for the diagnosis of coronary artery disease. However, in the current era of attention to cost effectiveness, the ability of a non-invasive test to predict outcomes, and therefore assist in clinical decision making, is paramount. As a reflection of the relative youth of this technique, there are fewer data using stress echocardiography to assess prognosis than there are using nuclear imaging. However, using both exercise and pharmacological stress echocardiography, the presence of ischaemia is strongly predictive of the recurrence of a subsequent cardiac event. Moreover, during pharmacological stress testing, the ischaemic threshold may be used to further stratify the risk of a positive test. More studies are needed in large populations to establish the prognostic role of stress echocardiography, as in independent predictor of outcome, incremental to clinical and stress testing data.