Due to the strenuous nature of the test, treadmill exercise test needs a good clinical evaluation prior to the test to exclude potential contraindications which may compromise the safety of the individual. A recent acute myocardial infarction with 2 days is an absolute contraindication. But a modified test with lower target heart rate may be conducted in stable persons prior to discharge for risk stratification. Yet in this era of early angiography and intervention, that is seldom needed. High-risk unstable angina is another absolute contraindication. In low risk unstable angina, it may be considered with due precautions, for risk stratification. An occasional risk of precipitation of myocardial infarction has to be considered. Uncontrolled cardiac arrhythmia with hemodynamic compromise is another absolute contraindication and so is acute infective endocarditis. Severe symptomatic aortic stenosis is an absolute contraindication for exercise testing. Then there is a long list, all for obvious reasons: Acute pulmonary embolism or pulmonary infarction and acute myocarditis or pericarditis. Any physical disability that precludes safe and adequate exercise is an important contraindication. There is also a list of relative contraindications in which risk benefit ratio has to be carefully assessed before proceeding with exercise testing.