Objective: To investigate the application value and correlation of three-dimensional spot tracking (3D-STI) echocardiography and electrocardiogram in apical hypertrophic cardiomyopathy (AHCM).Methods: 30 patients with AHCM admitted to the imaging department of our hospital from January 2020 to January 2022 were selected as the observation group, and another 24 healthy volunteers were selected as the healthy group. Both groups received 3D-STI echocardiography and electrocardiogram. The parameters of 3D-STI echocardiography and electrocardiogram were compared between the two groups, and the diagnostic efficacy and correlation of the two diagnostic methods were analyzed.Results: The 3D-STI strain parameters of the anterior wall, ventricular septum, inferior wall, lateral wall and left ventricle in the observation group were lower than those in the healthy group (P<0.05). The ECG parameters of RV3+SV1, SV1+RV5, RV2+SV1, total ΣQRS of 12 leads and SV3+RaV in the observation group were higher than those in the healthy group (P<0.05). ROC curve shows that, The strain test parameters (ACU=0.835, 0.876, 0.854, 0.779, 0.863,P<0.01) of the anterior wall, ventricular septum, inferior wall, lateral wall, and left ventricle as well as the cardiogram test parameters of SV3+RaVL, SV1+RV5, total ΣQRS of 12 leads, RV2+SV1, RV3+SV1 (ACU=0.670,0.982,0.851, 0.967,0.991,P<0.01) had certain diagnostic value for AHCM. Echocardiogram parameters of 3D-STI were highly correlated with electrocardiogram parameters (r=0.745, P<0.001).Conclusion: Both 3D-STI echocardiography and electrocardiography have some diagnostic value for AHCM, and the two parameters are highly correlated, so the two can be combined for clinical diagnosis.