Dobutamine stress echocardiography(DSE) has a modest sensitivity for detecting single- vessel coronary artery disease(CAD). This study assessed the additional diagnostic value of new or worsening wall motion abnormalities during recovery after acute administration of β blockers. The study population consisted of 200 patients(mean 59± 11 years of age, 144 men), who underwent DSE. Images were acquired at rest, low dose, peak dose, and during recovery. Patients received intravenous metoprolol(1 to 5 mg/min). The dose was adjusted to achieve a recovery heart rate within a 10% range of heart rate at rest. Coronary angiography was performed within 2 months. Inducible new wall motion abnormalities were observed in 168 patients(84% ) at peak stress. An additional 14 patients(7% )developed new or worsening wall motion abnormalities during recovery. CAD was detected in 182 patients(86 had single- vessel CAD). Sensitivity, specificity, and accuracy of DSE were 88% , 65% , and 73% at peak stress and 97% , 65% , and 74% during recovery. Sensitivity was particularly higher during recovery than during peak stress in patients with single- vessel CAD(98% vs 81% , p< 0.001). In conclusion, assessment of wall motion abnormalities during the recovery phase after acute β blockade improves sensitivity of DSE, particularly in patients with single- vessel CAD. Dobutamine stress echocardiography (DSE) has a modest sensitivity for detecting single-coronary artery disease (CAD). This study assessed the additional diagnostic value of new or worsening wall motion abnormalities during recovery after acute administration of β blockers. The study population consisted of Images were acquired at rest, low dose, peak dose, and during recovery. Patients received intravenous metoprolol (1 to 5 mg / min). The dose was adjusted to achieve a recovery heart rate within a 10% range of heart rate at rest. Coronary angiography was performed within 2 months. Inducible new wall motion abnormalities were observed in 168 patients (84%) at peak stress. An additional 14 patients ( 7%) developed new or worsening wall motion abnormalities during recovery. CAD was detected in 182 patients (86 had single-vessel CAD). Sensitivity, specificity, and accuracy of DSE were 88%, 65%, and 73% at peak stress and 97%, 65%, and 74% during recovery. Sensitivity was particularly higher during recovery than peak stress in patients with single-vessel CAD (98% vs 81%, p <0.001). In conclusion, assessment of wall motion abnormalities during the recovery phase after acute β blockade improves sensitivity of DSE, particularly in patients with single-vessel CAD.