I am honored to give this lecture in memory of Dr Mario S. Verani, a friend and a respected colleague in the field of nuclear cardiology. Dr Verani made many immense contributions to the field of nuclear cardiology during his lifetime. He was a pioneer in the field of pharmacologic stress imaging and played a leading role in validating the utility of intravenous adenosine infusion for stress imaging in detecting significant coronary stenoses and assessing prognosis. He and his colleagues at Baylor reported that pharmacologic stress imaging could separate high- and low-risk patient subsets after acute myocardial infarction, particularly among patients who underwent thrombolytic therapy. He informed us that certain drugs that patients took could influence perfusion defect severity. This work led to a clinical study showing that ischemic defect size could be substantially reduced with medical therapy in patients who had recently had an acute infarction. An outcome of this observation was the launching of the INSPIRE (adenosINe technetium-99m Sestamibi single-photon emission computed tomography Post-InfaRction Evaluation) trial in which postinfarction patients are randomized to medical therapy or revascularization. Dr Verani was an able debater when assigned the position for advocating for stress radionuclide perfusion imaging against stress echocardiography. He engaged in these debates with substantial knowledge but always with a touch of humor. Dr Verani's courage was an inspiration to all of us during his illness. His legacy as a pioneer will endure as the field of nuclear cardiology continues to mature and expand.