Objective To evaluate the left ventricular segment and overall systolic function in patients with coronary heart disease using three-dimensional speckle tracking imaging (3D-STI).Methods In 50 cases of echocardiography showed no obvious segmental wall motion abnormalities but coronary angiography (CAG) diagnosed CHD patients as the experimental group, while 30 cases of 30 cases of suspected coronary heart disease (CHD), but the two-dimensional echocardiography and coronary angiography were normal as control group. The left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were measured by 3D-STI, M, Teichholz and two-dimensional biplane Simpson methods in two groups. Strain parameters obtained with 3D-STI software ((left ventricular peak systolic circumferential strain (LS), left ventricular peak systolic circumferential strain (CS), left ventricular peak systolic radial strain (RS) and left ventricular systolic peak area strain (AS)), bovine map strain curve of left ventricular segment and time - 17 left ventricular strain; CAG results as the gold standard, the correlation parameters and CAG results are compared with the three methods.Results The cardiac function parameters (LVEDV, LVESV, LVEF) of the three groups in the control group were not statistically significant (P > 0.05). The cardiac function parameters (LVEDV, LVESV, LVEF) of the three methods in the experimental group were compared, the difference was statistically significant (P < 0.05). The cardiac function parameters (LS, CS, RS, AS) between the different segments of coronary artery in the experimental group were statistically different (P < 0.05) by 3D-STI method. The difference of 3D-STI parameters between the two groups (GLS, GCS, GRS, GAS) was statistically significant (P < 0.05).Conclusion 3D-STI can better assess coronary artery disease, segmental lesion and whole left ventricular systolic function, which can help the clinical diagnosis of cad.