Objective To investigate the reliable parameters of the efficacy of CRT on patients with CHF evaluated by 3D-STI. Methods Thirty-six patients with CHF were performed by three-dimensional speckle tracking imaging (3D-STI) before and at one week, one month and three months after CRT, respectively. The left ventricular end systolic volume (3D-LVESV), the left ventricular ejection fraction (3D-LVEF) and the left ventricular dys-synchrony parameters which include the standard deviation of time to peak (AT-SD) and the maximum difference of time to peak (AT-Dif) of radial strain, circumferential strain and area tracking in the 16 left ventricular segments and the changes of 3D-LVESV, 3D-LVEF (ΔLVEF), AT-SD (ΔAT-SD) and AT-Dif (ΔAT-Dif) at 3 months after CRT were determined. Forty normal volunteers as the controls were performed 3D-STI only once. Results AT-SD, AT-Dif of three kinds of strain, LVESV of the patients in both effective and non-effective groups were significantly higher than those in the control group before CRT (P < 0.05). AT-SD, AT-Dif of three kinds of strain in the CRT effective group were significantly higher than those in the CRT non-effective group , whereas 3D-LVESV and 3D-LVEF were not significantly different between these two groups before CRT. For the CRT effective group, one week after CRT, all of the left ventricular dyssynchrony parameters were decreased (P < 0.05, respectively). For the CRT non-effective group, the changes of total assessment parameters after CRT were not significant (P > 0.05). ΔAT-SD and ΔAT-Dif were negatively correlated with ΔLVEF. Conclusion 3D-STI can efficiently evaluate the short-term efficacy of CRT , and the area tracking is a reliable parameter to predict and assess CRT efficacy.