A VALIDATED TECHNIQUE: Effort sonography has been validated for the assessment of myocardial ischemia and is now widely used in many centres in the United States. DIAGNOSTIC PERFORMANCE: Is superior to that of effort electrocardiograms, with greater sensitivity in men and better specificity in women. Compared with myocardial scintigraphy, with comparable diagnoses, effort sonography is a non-radiating and more economic examination which is easier to perform. FOR PROGNOSTIC ASSESSMENT: Effort sonography provides supplementary prognostic value, compared with clinical variables and effort electrocardiograms, notably in predicting mortality in the general population and severe cardiac events in women, diabetic patients and the elderly. The interest of effort sonography for studying myocardial viability and in the assessment of valvulopathies is presently under validation.