Abstract: Myocardial disease is a group of cardiovascular diseases that are impaired by cardiac structure and wall function, leading to abnormal cardiac movement and progressive cardiac dysfunction. It often complicates arrhythmia, heart failure and even sudden cardiac death, which affects the quality of life and human health. Therefore, it is particularly important to discover the change of myocardial abnormality through non-invasive, convenient and effective examination. Because of its economic, non-invasive, simple, repeatable and other advantages, echocardiography has become an important examination method for clinical observation of myocardial movement and evaluation of cardiac function. With the rapid development of science and technology, the application of various new technologies in echocardiography is also rapidly changing. Among them, speckle tracking imaging technology is particularly prominent. Speckle tracking imaging tracks cardiac motion by identifying acoustic spots on the myocardium, analyzing myocardial deformation, and dynamically observing cardiac motion and hemodynamic changes to assess myocardial systolic and diastolic functions locally and globally. Compared with the traditional ultrasound technique, which is limited to evaluating the overall function of the heart, speckle tracking imaging can better reflect the local myocardial function and is independent of angle between the beam direction and the wall motion direction. Myocardial movement and cardiac function have higher accuracy and the clinical value is more impressive. This article aims to review the theoretical basis of speckle tracking imaging and its clinical application in myocardial disease.