The diagnostic accuracy of detecting individual coronary artery lesions using dobutamine stress echocardiography was evaluated in 206 patients with clinical manifestations of angina pectoris. The sensitivity, specificity, and accuracy in detecting individual coronary artery lesions was described. The sensitivity was higher in the single-vessel group than in the double- or triple-vessel group. Furthermore, the sensitivity of dobutamine stress echocardiography in localizing vascular territories was greater for proximal segment lesions than for distal segment lesions. The increment of total score and score index at peak dose did not reach statistical significance between the left main lesion and the double-vessel lesions of left anterior descending artery and left circumflex artery (4.88 ± 1.44 vs. 3.79 ± 0.39, nonsignificant; 0.83 ± 0.25 vs. 0.54 ± 0.06, nonsignificant). In conclusion, although dobutamine stress echocardiography is sensitive for diagnosing coronary artery disease, localizing individual coronary artery lesions is less sensitive for triple-vessel disease and distal lesions.