Obesity hypoventilation syndrome (OHS) is characterized by morbid obesity; most patients have class 3 obesity with a body mass index (BMI) > 35 kg/m², which is linked to breathing disorders during sleep and hypoventilation during the day, manifested as hypercapnic symptoms. Speckle tracking echocardiography (STE) provides segmental or global measurement of myocardial deformation, or "strain," in all heart chambers. It has the benefit of circumventing many of the conventional echocardiographic limitations. Our study aimed to develop an echocardiographic screening method for OHS and to assess its severity by using two-dimensional (2D) speckle tracking echocardiography (STE) for the early identification of subclinical LV impairment.