Abstract: Objective To explore the value of multi-slice spiral CT and echocardiogram in evaluating the right heart function in patients with acute pulmonary embolism. Methods A total of 90 patients with acute pulmonary embolism admitted from October 2017 to December 2019 were retrospectively selected as observation group, and 90 patients without pulmonary embolism who received physical examination during the same period were selected as control group. The results of multi-slice spiral CT test, echocardiogram test and cardiac function［plasma brain natriuretic peptide(BNP), left ventricular ejection fraction(LVEF), and left ventricular end-diastolic diameter(LVEDd)］were recorded in two groups. Results The findings of multi-slice spiral CT showed that ratio of the maximum inner diameter of right ventricle to left ventricle(RVD/LVD), the ratio of the maximum distance between the left ventricle and right ventricle(RV-LD/LV-LD), and the ratio of the maximum cross-sectional area of right ventricle to left ventricle(RVA/LVA)of the observation group were significantly higher than those of the control group(P<0.05), but the ratio of the inner diameter of main pulmonary artery to the aorta(PA/AO)between two groups showed no significant difference(P>0.05). The findings of echocardiogram showed that the ratio of left to right ventricular transverse diameter(RVTD/LVTD), pressure difference of tricuspid regurgitation(TRPG), inner diameter of the main pulmonary artery(PA)of the observation group were significantly higher than those of the control group(P<0.05); the level of BNP of the observation group was significantly higher, and left ventricular - end-diastolic diameter(LVEDd)was significantly greater, and left ventricular ejection fraction(LVEF)was significantly lower than those of the control group(P<0.05). Conclusion Multi-slice spiral CT and echocardiography can provide reliable imaging basis for the evaluation of right heart function in patients with acute pulmonary embolism.