Background- Afterload is expected to increase with pneumatic compression of the lower extremities. Thus, left ventricular(LV) wall stress, the most important factor determining myocardial oxygen, demand will also increase, leading to an increase in sensitivity of dobutamine stress echocardiography(DSE) or shortened time to positive response.The purpose of this study was to evaluate the effect of pneumatic compression of lower extremities on the diagnostic accuracy of DSE. Methods- In 40 patients who underwent DSE and were anticipating coronary angiography(CAG), DSE was repeated with pneumatic compression(100mmHg) of lower extremities(DSEcomp) prior to CAG. Sensitivity and specificity of DSE and DSEcomp were determined based on CAG. Results- All patients tolerated pneumatic compression of lower extremities during the tests. LV end-systolic volume(p=0.042) and end-systolic wall stress(p=0.036) were significantly greater in the DSEcomp than DSE. In 3 patients with false negative results in DSE, DSEcomp showed positive responses, causing a significant increase in sensitivity from 75% to 94%(p=0.045). Only 1 patient with true negative result in DSE was interpreted as showing positive response in DSEcomp, resulting in a decrease in specificity from 88% to 83%(p=NS). In 11 of 13 patients with true positive results both in DSE and DSEcomp, positive responses were seen at least 1 stage earlier in DSEcomp compared to DSE. Conclusions- Pneumatic compression of lower extremities increases the sensitivity of DSE and shortens the time to positive response.