Background: Most of stress echocardiographic studies have been used to detect coronary artery disease (CAD). The prediction of severity of coronary stenosis using a stress echocardiography has not been widely investigated. We postulated that the severity of CAD can be predicted by ischemic threshold such as workload and double product using a supine bicycle echocardiography (SBE). Methods and Results: We studied supine bicycle echocariograms of 104 patients (mean age 57 짹 11 years, 37 women). Ninety-one patients underwent both SBE and coronary angiography. The SBE protocol started at 25 watts with increments of 25 watts every 3 minutes. We interpreted images of all stages of exercise displayed. Eighty-six percentage of patients exercised 75 watts or more; Seventy-seven percentage of patients achieved a double product > 20,000. The inverse correlation was significant between double product at the occurrence of ischemia and LAD (r=-0.67, p<0.001), and non-LAD (r=-0.587, p<0.001) stenosis. A similar correlation was also present between workload at the time of development of ischemia and LAD (r=-0.422, p<0.001), and non-LAD (r=-0.546, p<0.001) stenosis Conclusion: The workload or double product at the time of development of ischemia was related significantly to stenosis severity.