The transesophageal echocardiographic approach improves the diagnostic power of transthoracic stress echocardiography. However, it is a seminvasive test and its safety is not well established. Our objective was to compare the incidence of complications of transesophageal and transthoracic dobutamine echocardiography. We collected data from 63 patients with inadequate transthoracic window, who underwent transesophageal dobutamine echocardiography and were compared with 100 patients in whom the transthoracic approach was diagnostic. Baseline blood pressure and heart rate were higher in the first group. There were no differences in those parameters at the end of the test. Neither were atropine administration and side effects more frequent in any of the groups. There were no cases of ventricular fibrillation, ventricular tachycardia, acute myocardial infarction, intractable angina or intolerance to the probe. Side effects were equally present in both groups. Transesophageal dobutamine stress echocardiography is a safe test that can be used in patients with coronary artery disease and poor transthoracic window.