Background: Ankylosing spondylitis (AS) is a chronic inflammatory condition that affects the sacroiliac, and peripheral joints. Systolic dysfunction in AS by conventional assessment may not detect early impairment, so we aimed to study the role two-dimensional (2D)-speckle tracking echocardiography (STE) in assessment of the ventricular function and correlate these findings with AS disease activity score (ASDAS). Methods: This study is a case-control study involving 135 participants; they were classified into three groups, inactive group (I) 57 cases, active group (II) 33 cases, and 45 control group (III) . The ASDAS was calculated for all patients. Laboratory parameters ;c–reactive protein (CRP),lipid profile, conventional echocardiographic assessment of ventricular systolic function and (2D) (STE) on both venticles were done Results: ASDAS was significantely high in the the active group (II). Right ventricular free wall strain (RVFWS) was more impaired in the same group p-value <0.001. Pulmonary artery systolic pressure (PASP) was also high in the same group p-value <0.001. AS patients were divided into two subgroups according to drug type biological 70 cases versus non-biological 20 cases. RVFWS was more impaired in the biological drug group -18.35%±3.08 versus -20.76±2.21 in the non-biological group, p-value 0.002. The predictor of impaired RVFWS in AS was PASP (p= 0.001), Exp (B) 1.143, 95% C.I: 6.895 to 13.714. RVFWS had a significant negative correlation with ASDAS-CRP, and PASP. Conclusion: Impaired RVFWS was detected in AS patients and was associated high disease activity score. Keywords: Ankylosing spondylitis (AS), Speckle tracking echocardiography (STE), Ankylosing spondylitis disease activity score (ASDAS). INTRODUCTION nkylosing spondylitis (AS) is a chronic inflammatory disease that first manifests in the second or third decades of life and affects the spine, sacroiliac, and peripheral joints. According to the most recent meta-analysis, Asia has a 16.7 per 10,000 prevalence rate for AS [1]. Several extra-articular manifestations have been reported. Cardiovascular disorders (CVDs), which are estimated to affect 10% of patients, have been reported to be more prevalent in AS patients than in the general population [2]. The mortality rate in AS is one and a half folds more than that of the general population and twenty to forty percent of these are due to cardiovascular events [3]. It is well established that the inflammatory mediators produced by AS directly impact cardiovascular risk factors and the atherosclerotic process. Studies have shown that an elevated level of C-reactive protein (CRP), tumor necrosis alpha (TNFα), inflammatory mediators (IL-6), and myocardial