Background: An initial assessment method for coronary artery disease (CAD) is echocardiography, which aids medical professionals in the diagnosis and prognostication of cardiac conditions. Visual assessment of wall motion anomalies, however, is not always successful in differentiating between myocardial ischemia that is less obvious or brief. Since it can locate ischemic territories in accordance with coronary lesions and identify subtle myocardial damage, speckle tracking echocardiography (STE) is a widely accessible noninvasive tool that can quickly and easily provide additional information over basic echocardiography. This allows for a clear visualization with a "polar map" that is useful for differential diagnosis and management. As a result, it has been used more often in both acute and chronic coronary syndromes with stress and rest echocardiogram, demonstrating positive outcomes in terms of left ventricular remodeling, clinical outcome prediction, CAD prediction, and the presence and measurement of new or residual ischemia. This review's objective is to present the most recent data on STE's value in CAD assessment and follow-up. Conclusions: Beyond ECG and biomarkers, echocardiography is a milestone for the evaluation of CAD in acute and chronic settings. STE could provide an additive value over visual wall motion assessment both for diagnostic and prognostic assessment, and the inclusion of LVGLS in clinical diagnostic workup of these patients is supported by plenty of evidence and clear advantages overweighing the intrinsic limitations of STE technique. However, further studies are needed to confirm the potential value of other chambers' strain.