Although tissue Doppler echocardiography is useful in assessing regional myocardial function, Doppler-angle dependency greatly limits its clinical application. By contrast, speckle tracking echocardiography automatically tracks myocardial ultrasound speckle, making it possible to assess myocardial velocity and strain and strain rate irrespective of direction of myocardial motion. Speckle tracking echocardiography is thus useful in assessing myocardial function in all ventricular walls, providing information that is especially important in assessing ventricular dyssynchrony and myocardial ischemia associated with postsystolic shortening. Ventricular dyssynchrony is assessed by measuring the time difference of peak myocardial strain among the walls and is reported to be robust than that between peak systolic myocardial velocities. Moreover, recent advances enable estimation of subendocardial and subepicardial myocardial function separately. One interesting application of speckle tracking echocardiography is the ability to assess ventricular rotation and wringing motion. Twist and untwist are assessed based on the difference between basal and apical rotation. Untwisting is mainly seen during isovolumic relaxation and may be related to diastolic relaxation, suggesting that untwist could prove useful in assessing grade of diastolic dysfunction. Speckle tracking echocardiography has been applied in two-dimensional echocardiography, where it can assess myocardial motion in a more physiological manner and is likely to open new avenues for research and clinical application, Note, however, that three-dimensional speckle tracking echocardiography has just become available.