Aim To investigate the clinical value of real-time three-dimensional echocardiography (RT-3DE) combined with autostrain right ventricle (RV) technology in evaluating right ventricular function in patients with coronary heart disease (CHD)involving the right coronary artery stenosis. Methods A total of 132 patients with suspected CHD were enrolled. According to the results of coronary angiography, they were divided into control group without coronary artery stenosis of 50%, CHD without involving the right coronary artery stenosis group (simple CHD group), CHD involving the right coronary artery stenosis group. The three groups of subjects were analyzed by conventional echocardiography, autostrain RV technology and RT-3DE. Results Compared with control group, at the basal levels of the right ventricular free wall-longitudinal strain (Basal RVFWSL), at the middle levels of the right ventricular free wall-longitudinal strain (Medial RVFWSL), at the apical levels of the right ventricular free wall-longitudinal strain (Apical RVFWSL), right ventricular free wall-longitudinal strain (RVFWSL), right ventricular 4 chamber longitudinal strain (RV4CSL), right ventricular ejection fraction (RVEF), right ventricular stroke volume (RVSV) and right ventricular stroke volume index (RVSVI) were decreased, while right ventricular end-systolic volume (RVESV), right ventricular end-systolic volume index (RVESVI) were increased in simple CHD group and CHD involving the right coronary artery stenosis group. The differences were statistically significant (all P＜0.05). ROC curve analysis showed that RVFWSL of two-dimensional speckle tracking imaging (2D-STI) and RVEF of RT-3DE had higher diagnostic efficiency, with a sensitivity of 90.9% and a specificity of 95.3%. Conclusions RT-3DE combined with autostrain RV technology can improve the accuracy of evaluating right ventricular dysfunction in patients with CHD involving the right coronary artery stenosis, which provides a basis for early clinical treatment and has good application value.