Background: Aortic stiffness is a hallmark of aging, and classic cardiovascular risk factors play a role in accelerating this process. Current changes in medicine, which focus on preventive care, have led to an interest in noninvasive evaluation of aortic stiffness. Aortic stiffness has emerged as a good tool for further risk stratification because it has been linked to increased risk of atherosclerotic heart disease, myocardial infarction and heart failure. Objective: To assess feasibility of aortic root 2D-ST echocardiography for the early prediction of ischemic heart patients and its correlation with aortic stiffness parameters. Patients and Methods: Seventy patients were included in this study which further subdivided into 45 ischemic patients (ischemic group) and 25 non ischemic patients (normal group). Informed consent, detailed history, physical examination, resting 12 leads ECG, full laboratory investigations, conventional 2D echocardiography, aortic root 2D-ST echocardiography and coronary angiography were done. The study was performed at Bab Al-Sharia University Hospital during the period from April 2020 to October 2020. Results: Global circumferential ascending aortic root strain (CAAS) and longitudinal ascending aortic root strain (LAAS) significantly decreased with the presence of significant coronary stenosis, both of them decreased incrementally with increasing severity of CAD, and there was significant correlation between aortic root 2D strain parameters and aortic stiffness parameters. Conclusion: Global circumferential ascending aortic root strain and longitudinal ascending aortic root strain assessed by aortic root 2D-ST echocardiography at rest were an independent predictor of significant CAD. Furthermore, global CAAS and LAAS were related to the severity of CAD and capable of identifying multivessel disease.