Background: Reverse redistribution of thallium-201 (²⁰¹TI) imaged through scintigraphy can be helpful in assessing the myocardial viability among patients with stable coronary artery disease (CAD). Knowledge about reverse redistribution and its association with long-term cardiac outcomes is limited. Materials and methods: Adult patients with stable CAD were eligible for inclusion. Patients underwent exercise-redistribution thallium single-photon emission computed tomography (SPECT) and were followed up for 3 years. Patients were assessed by echocardiography for left ventricular ejection fraction (LVEF) and regional wall motion abnormalities, bicycle testing for exercise duration, and thallium SPECT for myocardial ischemia and viability. Results: A total of 156 patients with well-developed collaterals were studied. At the 3-year follow-up, patients showing reverse redistribution depicted significantly improved exercise tolerance (≥85%; p < 0.001); improved LVEF (p < 0.001); less myocardial necrosis (p < 0.05); wall motion parameters (p < 0.001); fewer angina episodes during follow-up (p = 0.02), and fewer ischemic events irrespective of being treated with oral medial therapy or percutaneous coronary intervention (PCI) (p < 0.001). Conclusion: Findings suggest that adequately treated chronic CAD patients with reverse redistribution may show a better prognosis with less likelihood of adverse cardiovascular events after 3 years.