Abstract The assessment of coronary flow reserve is an extremely important step in stress echocardiography, both within and outside the context of coronary artery disease. For some, it is seen as an impossible parameter; for others, it is essential. In any case, everything begins with the proper visualization of the coronary arteries at rest. In this article, we will address theoretical and practical concepts for incorporating coronary flow study into the routine of the echocardiographer.