Background: The prognosis for inferior wall myocardial ischemia is better than that of other locations. Objective: The aim of the study was to assess the function of left and right ventricles (LV and RV) in patients with inferior wall perfusion defects. Subjects and methods: The present study included 112 patients with positive inferior wall perfusion defect by single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). The echocardiography was done within one month after MPI. Results: There were decreased LV and RV functions as assessed by 2D speckle tracking echocardiography (2D-STE). and 3D echocardiography. The 2D-STE was able to identify subtle LV and RV dysfunction in about 72.5% and 40% respectively while with 3D echocardiography, LV and RV dysfunction was 75% and 46.2% respectively. Conclusion: SPECT as a non-invasive technique; is an important tool to detect extent of myocardial ischemia. 2D speckle tracking and 3D echocardiography are able to identify subclinical LV and RV dysfunction.