Background: peripheral arterial disease (PAD) is estimated to affect 202 million people worldwide, with prevalence that is increasing over time. PAD represents a local manifestation of systemic atherosclerosis and portends a 2-6 fold increase in both cardiovascular and cerebrovascular events with an annual mortality rate of 4-6%(1,2) . Aim of the Work: the aim of this work was to detect left ventricular subclinical dysfunction using 2- dimensional speckle-tracking echocardiography (2D-STE) in patients with peripheral arterial disease. Patients and Methods: the ethical approval was obtained from the hospital Ethical Research Committee and each patient entering the study signed an informed consent. In a case-control study, 30 patients included was diagnosed with peripheral arterial disease and 20 control. They were recruited from Vascular department at Al-Hussein and Bab El-She'riya University Hospitals during the period from June 2018 to November 2018. Results: there was moderately strong significant correlation between ABI and left ventricle 2d speckle tracking echocardiography (2D-STE) (GLS% (p=0.003, r=0.52), AP4% (p=0.001, r=0.57), AP3% (p= 0.004, r=0.51) and AP2% (p=0.005, r=0.50)). This correlation was obvious according to limb affection (one limb vs. both limbs, GLS% p=0.025, AP4% p=0.038, AP3%=0.013 and AP2%=0.046) and severity (severe arterial disease vs. moderate arterial disease vs. some arterial disease subgroups GLS% p=0.003, AP4% p=0.001, AP3%=0.002 and AP2%=0.015). Also, there was moderately strong significant correlation of ABI with left ventricle systolic function (p=0.011, r=0.46) while other conventional echo parameters were of no significance with decline in ABI. Conclusion: peripheral arterial disease patients had lower global and segmental longitudinal strain than the healthy subjects and this was more prominent either with severity or limb affection. This study showed that even there is correlation between decline ABI and left ventricular systolic function EF% but LV GLS offer a better economic way to detect subclinical dysfunction in asymptomatic patient.