Objective：To evaluate the left ventricular myocardial stratification strain in uremic patients with chronic renal failure by two-dimensional speckle tracking technique, and to study the clinical value of two-dimensional STI in evaluating the degree of myocardial involvement in patients with chronic renal failure (uremic stage). Methods：Sixty uremic patients diagnosed clinically and pathologically were selected as case group and 60 healthy volunteers as control group. The longitudinal and circumferential strain peaks of the left ventricular myocardium in the subendocardial, middle and subepicardial layers were measured by STI technique, and the results were compared and analyzed.Results：The LS and CS of left ventricular myocardium in both groups decreased from Endo to Epi, and increased from basal to apical segment with statistical significance (P < 0.05); the LS, GLS and △GLS of each layer of two-chamber, three-chamber and four-chamber cardiac sections in the case group were lower than those in the control group (P < 0.05); there was no significant difference in CS, GCS and △GCS of basal, middle and apical segments between the two groups (P < 0.05). There was no significant difference (P > 0.05). Conclusions：Left ventricular myocardium and systolic function were damaged in patients with chronic renal failure before ejection fraction decreased, and myocardial full-thickness systolic function was impaired to varying degrees, of which subintimal myocardium was the most severely impaired.