Abstract Background acute ischemia causes myocardial necrosis with subsequent endogenous inflammation, leading to myocardial damage, ventricular dilatation, dysfunction, cardiac remodeling and dysfunction. Colchicine is a substance with potent anti- inflammatory properties, which allows for safe use in patients with cardiovascular disease, STE-based GLS can be used to assess global and regional LV function. The aim of this work is to study the efficacy and safety of colchicine administration on LV systolic function in patients with STEMI underwent primary PCI by using 2D speckle tracking Echocardiography. Methods The study included 200 STEMI patients divided into 2 equal subgroups; colchicine group, and control group. speckle tracking echocardiography was done to the whole subjects to asses LV systolic function. Results Assessment of LV systolic function (EF%) as calculated by Simpson’s method showed higher significant improvement in colchicine group (P-value = 0.011) and highly statically significant average GLS by speckle tracking echocardiography during follow up after 6 months, also colchicine was non inferior to placebo regarding acute and chronic complication. Conclusion the safety and efficacy of colchicine in anterior STEMI patients underwent PPCI. It significantly improve LV systolic function measured by Ejection fraction and average GLS speckle tracking Echocardiography after 6 months follow up.