Objective To explore and compare the clinical values of three-dimensional ultrasound and magnetic resonance imaging (MRI) in evaluating the left ventricular function of patients with coronary heart disease (CHD) complicated with ventricular aneurysm. Methods The clinical data of 40 cases of patients with CHD complicated with ventricular aneurysm treated with surgery in the Third Affiliated Hospital of Xinxiang Medical College and the Second Affiliated Hospital of Zhengzhou University were analyzed retrospectively. The ventricular aneurysm motion, ventricular aneurysm size and the the left ventricular function examination results by three-dimensional ultrasound and MRI were compared. Results Preoperative MRI examination showed that there were 59 paradoxical motion segments and 62 non-motion ventricular wall segments among 40 patients, of which 13 segments were recoverable by preoperative determination and were in accordance with intraoperative diagnosis. And postoperative MRI showed there were wall thickening changes in the 13 segments. Three-dimensional ultrasound results showed that there were 29 paradoxical motion segments and 28 non-motion wall segments, of which 6 were recoverable. The coincidence rate of three-dimensional ultrasound was 39.67% in the diagnosis of wall motion. There were significant differences in the preoperative measured values of the left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) by two-dimensional ultrasound, three-dimensional ultrasound and MRI (P<0.05), and there was no significant difference in the postoperative measured values by two-dimensional ultrasound, three-dimensional ultrasound and MRI (P>0.05), and the measured values of LVEDV and LVESV by two-dimensional ultrasound were lower than those by MRI (P<0.05). The preoperative measured values of LVEF, LVEDV and LVESV by three-dimensional ultrasound had a good correlation with the measured values by MRI , and the rvalues were 0.65, 0.71, 0.74 (P<0.05). The postoperative measured values of LVEF, LVEDV and LVESV had a good correlation with the measured values by MRI, rvalues were 0.73 ,0.75, 0.76 respectively (P<0.05). Conclusion The measured values of left ventricular volume, function by three-dimensional ultrasound were close to the measured values by MRI among patients with CHD complicated with ventricular aneurysm, but the former one is poor in determining the accuracy of ventricular wall motion state, and MRI can accurately determine the left ventricular function of patients with CHD complicated with ventricular aneurysm.