Background: The accurate assessment of left ventricular (LV) function of patients with tricuspid atresia (TA) is of major important in the follow-up. The aim of this study was to evaluate systolic and diastolic LV function by real time 3-dimensional echocardiography (RT3DE) and tissue Doppler echocardiography (TDE) in patients with TA after palliative Fontan operation. Methods: Nine asymptomatic TA (type 1) patients aged 5.8 to 37 years were evaluated with standard conventional echocardiography, RT3DE and TDE. Eleven age-matched normal subjects were selected as controls. Results: Comparing with controls, the TA patients had normal LV end-diastolic volume (LVEDV) (TA: 76.7짹20.0 mL/m2 vs. control: 68.2짹9.5 mL/m2; P= 0.454), LV stroke volume (SV) (40.5짹10.6 mL/m2 vs. 39.2짹8.8 mL/m2; P= 0.851) and LV EF (53.1짹6.2 mL/m2 vs. 57.1짹6.6 mL/m2; P= 0.333) by measuring triplane Simpson���s method and normal LVEDV (70.3짹15.3 mL/m2 vs. 67.2짹10.2 mL/m2; P= 0.760), LV SV (35.3짹10.7 mL/m2 vs. 35짹4.0mL/m2; P= 0.960) and LV EF (48.7짹7.1 mL/m2 vs. 52.2짹1.9 mL/m2; P= 0.240) by measuring 3-D volume method. Mitral valvar E/A ratio (P=0.016), LV myocardial performance index (P=0.043), isovolemic contraction time (P=0.023) and mitral annular systolic (P=0.003) and early diastolic velocity (P<0.001) at the left lateral wall differed significantly between TA and control groups. LV longitudinal strain at basal anteroseptal and mid anteroseptal segments was significantly lower in TA group. In triplane tissue synchronization image, basal max delay, basal SD, all segmental maximum delay and all segmental SD were significantly increased in TA group. Peak radial strain at basal anteroseptal, basal anterior, apical area was significantly lower in TA group in comparison to normals. Circumferential strain and radial strain rate didn���t differ significantly. Conclusions: Asymptomatic TA patients had normal LV systolic function, abnormal diastolic function and abnormal myocardial wall motion. It needs to be assessed whether these are indexes of adverse prognosis in long-term surveillance of TA patients.