Objective To assess the value of three-dimensional speckle tracking echocardiography (3D-STE) in evaluating the left ventricular (LV) function in hyperuricemia patients. Methods We enrolled 40 healthy controls and 80 hyperuricemia patients and collected and analyzed full-volume 3D-STE images of the left ventricle in the apical four-chamber heart view. Laboratory tests and 3D-STE parameters, including stroke volume (SV), global longitudinal strain (GLS), and global circumferential strain (GCS), were compared between hyperuricemia patients and healthy controls. Results Hyperuricemia patients exhibited higher body mass index (24.70?±?2.9 vs. 21.83?±?2.4 kg/m2, P?=?0.001), C-reactive protein (5.82?±?9.4 vs. 1.12?±?1.8 g/L, P?=?0.012), alanine transaminase (34.26?±?26.6 vs. 17.60?±?13.0 U/L, P?=?0.011), aspartate transaminase (24.90?±?11.3 vs. 17.70?±?4.1 U/L, P?=?0.001), blood urea nitrogen (5.11?±?1.6 vs. 4.18?±?0.6 mmol/L, P?=?0.046), and serum creatinine (90.25?±?14.6 vs. 77.93?±?10.8 μmol/L, P?=?0.006) levels, as well as a lower estimated glomerular filtration rate (87.87?±?16.5 vs. 103.64?±?11.3 mL/min/1.73m2, P?=?0.002). The 3D-STE parameters reflecting LV function, including SV (54.71?±?9.6 vs. 61.92?±?14.4 mL, P=?0.024), GLS (??20.51?±?4.0 vs. ??23.20?±?4.0%, P?=?0.019), and GCS (??31.30?±?5.0 vs. ??35.65?±?2.5%, P