Abstract: Stress myocardial perfusion imaging and stress echocardiography are both noninvasive diagnostic techniques. Both techniques are very valuable for assessment of diagnosis and risk stratification of patients with coronary artery disease, while both have their advantages and disadvantages. The overall sensitivity for diagnosis of coronary artery disease is higher by stress myocardial perfusion imaging than by stress echocardiography, whereas the specificity is slightly higher by the later.With regard to risk stratification of patients with coronary artery disease, stress myocardial perfusion imaging is more valuable than stress echocardiography. A normal stress myocardial perfusion imaging result indicates an exceedingly low risk even in patients with angiographic coronary artery disease.