Abstract: Objective To provide the evidence for the clinical diagnosis and treatment of heart disease in obesity patients by assessing their left ventricular systolic and diastolic function with echocardiography. Methods The left ventricle diastolic and systolic function in 132 obesity patients admitted to our hospital from March 2012 to July 2013 with their LVEF ≥ 50% measured by conventional echocardiography, tissue Doppler imaging and 3-dimensional speckle tracking imaging (3D-STI) were comparatively analyzed. Results The left atrium index(LAI), left ventriclar end-diastolic diameter(LVEDd), left ventriclar end-systolic diameter(LVESd), peak perfusion velocity of mitral valve at late diastolic phase (A), peak perfusion velocity of mitral annulus at late diastolic phase(A'), left ventricular mass (LVM) and global radial strain (GRS) were significantly higher, whereas the peak perfusion velocity of pulmonary vein at systolic phase (S), the ratio of peak perfusion velocity in mitral valve at early and late diastolic phase (E/A), the ratio of peak perfusion velocity in mitral annulus at early and late diastolic phase (E'/A'), global circumferential strain (GCS), global longitudinal strain (GLS) and global area strain (GAS) were signifcantly lower in obesity patients than in controls (P< 0.001). Univariate linear regression analysis showed that S, GLS, GCS, GRS and GAS were related with BMI in obesity patients. Stepwise regression analysis revealed that GCS was closely related with BMI (P=0.002). Conclusion 3D-STI can provide a new sensitive indicator for the clinical assessment of left ventricular systolic function in obese patients.