【Abstract】Objective Objective to investigate the clinical value of two-dimensional speckle tracking imaging (2D-STI) in the early diagnosis of neonatal asphyxia with myocardial damage. Methods Methods from July 2019to December 2020, 61 full-term asphyxiated newborns hospitalized in the Department of Neonatology, Affiliated Hospital of Youjiang Medical College for nationalities were selected. According to Apgar score, they were divided into mild asphyxia group (31 cases) and severe asphyxia group (30 cases). 30 normal full-term newborns hospitalized in the same period were selected as the control group. The serum creatine kinase isoenzyme (CK-MB), troponin (cTnT), left ventricular diastolic diameter (lvdid), left ventricular ejection fraction (LVEF), left ventricular short axis shortening rate (lvfs), Simpson's left ventricular ejection fraction (Simpson's EF), global strain gls-lax, gls-a4c, gls-a2c in each section were detected The correlation between gls-avg and CK-MB, cTnT was analyzed. Results There were significant differences in CK-MB and cTnT among the three groups (P < 0.05). There were no significant differences in gender, weight and gestational age among the three groups (P > 0.05). There was no significant difference in lvdid, LVEF, LVFS and Simpson EF among the three groups (P > 0.05). GLS-avg was negatively correlated with CK-MB (r = - 0.515, P = 0.000), GLS-avg was negatively correlated with cTnT (r = - 0.912, P = 0.000). Conclusion GLS-avg is highly correlated with CK-MB and cTnT. GLS-avg can be used as an early diagnostic index of myocardial damage in asphyxiated neonates.