Introduction: Chest pain is a common presentation in emergency units in daily life. Dobutamine stress echocardiography (DSE) was considered an early non-invasive method that help stratifying the risk for development of CVD. However, many patients experience chest pain shortly after DSE. Methods: 150 patients admitted to catheter unit in Cardiology Department at Al-Azhar university Hospitals between June 2021 and June 2022 with chest pain despite negative DSE. They all underwent coronary angiography. Results: 150 patients were included in the study. Their mean age was 50.99 ± 8.29 years old. 56.7% of patients were males. 24.7% of patients were diabetic. After PCA, 15.3% of patients had severe coronary arteries stenosis. We found that 6% of patients had severe stenosis of Left anterior descending and right coronary arteries (p<0.001). In addition, DM with other risk factors was significantly associated with development of severe stenosis of coronary arteries (P<0.001). Conclusion: 15.3 % of patients with chest pain following DSE had significant coronary arteries stenosis on PCA. DM was associated with that stenosis. That is why, in patients with negative DSE and chest pain, further investigations are required. Special emphasis should be directed to patients with more than one risk factor including diabetes mellitus.