Objective To explore application value of real-time three-dimensional echocardiography in assessment of left ventricular asynchrony in children with Kawasaki disease (KD). Methods Sixty children with KD were analyzed retrospectively, and 40 healthy volunteers were enrolled as control group. The two-dimensional echocardiographic features and ejection fractions measured by Simpson's method of 60 cases were analyzed and compared with the global ejection fractions measured by three-dimensional echocardiography. The regional volume-time curves of 17 segments were acquired automatically by real-time three-dimensional echocardiography and compared to the control group. Results In 60 cases, the ejection fractions measured by Simpson's method correlated moderately with the global ejection fractions measured by real-time three-dimensional echocardiography; and the regional volume-time curves of 17 segments arranged in disorder of different directions; and the time to the point with minimal systolic volume was discrete. Conclusion The regional volume-time curves of 17 segments are important in evaluating the left ventricular systolic synchrony.