ABSTRACT Objective To evaluate the left atrial （LA） systolic function in uremia patients with two-dimensional speckle tracking imaging and to confirm its clinical value. Methods This study inclued 60 uremia patients in our hospital, half of whom have the LAVI less than 32ml/m2 as the group A and the other with LAVI more than 32ml/m2 as the group B . 30 patients of the normal jection fraction of left ventricul were also enrolled in the study as the control group.LA peak systolic strain，LA peak early-diastolic strain and LA peak atrial systolic strain in longitudinal directions of all the subjects were measured with two-dimensional speckle tracking imaging and the measurements were compared among the three groups. Results compared with the control group，LA peak systolic strain，LA peak early-diastolic strain and LA peak atrial systolic strainin in both group A and group B were significantly decreased（P＜0.05）. LA peak systolic strain and LA peak early diastolic strain in the group B were significantly decreased（P＜0.05） when compared with group A, and LA peak atrial systolic strainin was significantly increased（P＜0.05）.Conclusions The speckle tracking imaging has the potential to detect the left atrial dysfunction in inuremia patients with the normal jection fraction of left ventricul which could provide useful information for clinical practice .