One hundred twenty-five patients (60 ± 10 years old, 60 women) with known (35, previous myocardial infarction) or suspected (90) coronary artery disease (CAD) and no more than 50% coronary stenoses underwent pharmacologic (48 dipyridamole and 77 dobutamine) stress echocardiography (SE) and prospective follow-up (36 ± 22 months) for cardiac death, nonfatal infarction, and unstable angina. The ability of clinical and SE variables to predict the outcome was assessed by the Cox model. A significant increase in the global chi-square of the model indicated an incremental prognostic value. Nine events occurred: 2 fatal and 5 nonfatal infarctions and 2 hospitalizations for unstable angina. Hypertension, positive SE, and peak wall motion score index were multivariate predictors of outcome, but SE provided an 87.5% increase in the global chi-square ( P < .001). Patients with positive SE had a significantly lower event-free survival compared with those with negative SE. Therefore, we conclude that SE provides incremental prognostic information in patients with chest pain without critical coronary artery disease. (J Am Soc Echocardiogr 2002;15:1285-9.)