Background: Hypertension is the most prevalent cardiovascular (CV) disorder, affecting 20–50% of the adult population in developed countries. Objectives: The aim of this study is to test the capability of real-time three-dimensional speckle tracking echocardiography (RT3D STE) in characterizing early abnormalities of left ventricular LV systolic dysfunction in hypertensive patients with normal LV systolic function by standard 2D echocardiography. Subjects & Methods: The study population included 150 consecutive hypertensive patients without complication and another age and sex matches 50 healthy controls. ECG, 2D and 4D echocardiography were performed for all cases. Results: There was evidence of ECG voltage criteria of LVH in about 72% of hypertensive patients which absent in healthy controls. By comparing both group there were no statistically significant difference regarding EF%, AO, ESD, EDD, EDV.ESV, while there were statistically higher significant value in the patients group regarding RWT, LVPWD, IVSD and LV mass with (P<0.001) compared to controls where there were low statistically significant higher value in the patients group regarding LA dimension and volume (P<0.05). Conclusion: 3D strain is an applicable technique; it can detect subtle or substantial changes of LV even with normal ejection fraction. The left ventricular strains (GAS, GLS and GRS) correlate negatively