Is it form or function? This question regarding therapy for stable ischemic heart disease remains after the results of the ISCHEMIA trial were published five years ago. The failure of the ischemia identified patients to benefit from revascularization, at least from hard cardiac events, convinced some that ischemia and ischemia testing were not important for decision making. Guidelines still recommend stress testing to identify ischemia but the unreliability of stress imaging to identify anatomic obstructions and the observations that the extent of anatomic disease is critical for selecting therapy has resulted in a shift in practice. This resulted in a decreased enthusiasm for stress testing and an increased interest in invasive coronary arteriography or coronary computerized tomography (CCTA) to identify candidates for revascularization and to plan an approach. Is there still a place for stress testing in the patient being considered for revascularization?