Mitral stenosis (MS) is a common disease that causes substantial morbidity. Timely recognition and treatment of the mitral stenotic lesion is very important. Stress echocardiography plays an important role in evaluating asymptomatic patients with significant mitral stenosis and symptomatic patients with only mild disease at rest. In patients with mitral stenosis, stress echocardiography protocols assess for the change in the mean transmitral pressure gradient and a peak pulmonary artery systolic pressure during exercise. In this review, clinical use of stress echocardiography in patients with mitral stenosis is summarized.