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. Methods Two-dimensional and three-dimensional transthoracic echocardiography was performed on 30 patients with CKF. The ejection fraction, mass and global peak longitudinal strain, global circumferential strain, global area strain, and global radial strain of the left ventricle were calculated. Results The ejection fraction, mass and global peak longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) in the CKF group were significantly lower than those in the control group. Simultaneously, the GLS, GCS, GAS and GRS were well correlated with the ejection fraction. For patients with normal ejection fraction in the CKF group, the GLS, GCS, GAS and GRS were lower than those in the control group, while the left ventricular mass was significantly higher in CKF patients than in the control group. For patients with hypertension in the CKF group, ejection fraction, GLS, GCS, GAS and GRS calculated using three-dimensional echocardiography were significantly lower than those in patients with normal blood pressure; however, the myocardial mass was higher. Conclusions The parameters (GLS, GCS, GAS and GRS) calculated using three-dimensional speckle-tracking software were lower in the CKF group. Simultaneously, the left ventricular mass was higher in CFK patients than in the control group, thus showing that the myocardial contraction function was impaired and that myocardial remodeling had occurred.