Background: Diastolic dysfunction is widespread among patients on dialysis and is associated with increased morbidity and mortality. Echocardiographic speckle tracking strain rate analysis may allow assessment of left ventricular diastolic function. Objectives: The purpose of this study was aimed to test the capability of speckle tracking diastolic strain rate to assess the clinical and subclinical left ventricular diastolic dysfunction in end stage renal disease patients who are on dialysis. Subjects and Methods: This prospective study included a total of 45 subjects, 30 of them were on dialysis, attending at the Outpatient Clinic, Department of Cardiology, Faculty of Medicine, Al-Azhar University Hospital and Nasr City Police Hospital. The included subjects were divided into three groups; Group (A) included fifteen healthy control subjects, Group (B) included fifteen patients with dialysis with normal diastolic function and Group (C) included fifteen patients with dialysis with diastolic dysfunction. Results: No significant differences were observed between control subjects and study population as regard age, sex, DM, smoking and Dyslipidemia. In the current study, comparison between the three groups revealed statistically significant difference in mean values of HTN. Comparison between the three groups revealed highly statistically significant differences in echocardiographic parameters that included E/A, E/e, LA volume, TR velocity and speckle tracking diastolic strain rate used in evaluation of Diastolic function “ P value 0.001 ". Conclusion: Two-dimensional speckle tracking could be used in assessment of diastolic dysfunction among people on dialysis dependent on speckle tracking diastolic strain rate.