Objective To establish a quantitative evaluation of the left ventricle’s systolic function in patients with chronic kidney failure (CKF) by three-dimensional speckle-tracking echocardiography(3D-STE). Methods Two-dimensional transthoracic echocardiography and three-dimensional transthoracic echocardiography were performed on 30 patients with CKF. The ejection fraction (EF), mass and global peak longitudinal strain (GL), global circumferential strain (GC), global area strain (GA), and global radial strain (GR) of the left ventricle were calculated. Results (1) EF, GL, GC, GA, and GR in the CKF group were significantly lower than in the control group. Meanwhile, GL, GC, GA, and GR were well correlated with EF. (2) For patients with normal EF in the CKF group, GL, GC, GA, and GR were lower than in the control group, while the left ventricular mass was significantly higher than in the control group. (3) For patients with hypertension in the CKF group, EF, GL, GC, GA, and GR calculated using three-dimensional echocardiography were significantly lower than in patients with normal blood pressure; however, the myocardial mass was higher. Conclusions Parameters calculated using three-dimensional speckle-tracking software were lower in the CKF group. Simultaneously, the left ventricular mass was higher than in the control group, showing that the myocardial contraction function was impaired and that myocardial reconstruction occurred.