Background: Speckle-tracking echocardiography (STE) is a noninvasive imaging technique that analyzes global and regional myocardial function. Aims: This study aimed to compare the assessment of the left ventricular (LV) function after percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) to left anterior descending artery (LAD) by STE. Settings and Design: One hundred patients presented to the catheterization laboratory and cardiothoracic operating room in Benha University Hospital and Kasr Al–Ainy University Hospital for PCI and CABG to LAD. Patients and Methods: This study enrolled 100 patients. They were divided into two groups: Group I: 50 patients with PCI to LAD and Group II: 50 patients with CABG to LAD. Echocardiography (conventional echocardiography and two-dimensional STE) was performed for all patients 24 h before and 1 month after the procedures. Statistical Analysis Used: Data management and statistical analysis were done using SPSS version 25. Results: There were significant increases in global circumferential strain (GCS) after CABG surgery with mean value of −17.8 before the procedure and −23.8 after it while there were no significant increases in global longitudinal strain (GLS) after the same procedure with mean value of −17.5 before the procedure and −18.1 after it. There were significant increases in GLS with mean value of −17.0 before PCI and −21.2 after it, and there were significant increases in GCS with mean value of −17.1 before PCI and −25.4 after it with improvement in myocardial function after this procedure. GLS and GCS were significantly higher in patients with PCI than patients with CABG with P < 0.001. Conclusions: GLS and GCS are more effective than the parameters of standard echocardiography such as the LV end-diastolic volume, LV end-systolic volume, wall motion score index, and ejection fraction for evaluating LV function after PCI and CABG surgery. GLS and GCS are significantly higher in patients with PCI than patients with CABG surgery to LAD.