Objective Exploring the clinical value of 4D-Auto-LAQ technology in evaluating early changes of left atrium function in patients with masked uncontrolled hypertension. Methods A total of 71 patients were selected for 24-h ambulatory blood pressure,based on the blood pressure the patients were divided into two groups: masked uncontrolled hypertension group (MUHT) and well-controlled hypertension group (WCHT) . We obtained left atrial volume parameters by 4D-Auto-LAQ: left atrium maximum volume (LAVmax) , left atrium pre-contraction volume (LAVpre) , left atrium minimum volume (LAVmin). After standardized with the body surface area we gained left atrium maximum volume index (LAVImax) , left atrium pre-contraction volume index (LAVIpre), left atrium minimum volume index (LAVImin). Then calculating left atrial emptying function: left atrial total emptying function (LAEF), left atrial passive emptying function (LApEF), left atrial active emptying function(LAaEF). Results Compared with the WCHT group, the left atrial parameters of the MUHT group had a significant increase in LAVImax, LAVIpre, LAVImin, LAaEF and reduce in LApEF (all P<0.05). The left atrial strain parameters of LASr、LAScd、LASct in the MUHT group were significantly lower than those in the WCHT group (all P<0.05). Pearson correlation analysis showed that LASr was positively correlated with E/e’ (r = 0.386, P=0.00), LAScd and LASct were not correlated with E/e’(P>0.05). Conclusion 4D-Auto-LAQ is an accurate and convenient technology in the measurement of left atrial volume and strain parameters, which can detect the early changes of left atrium function in patients with masked uncontrolled hypertension.