Objective To evaluate the changes of left ventricular spherical index and synchronicity in overweight and obese populations with real-time three-dimensional echocardiography, and to analysis the influence factors. Methods Totally 100 healthy people from the health management center of the affiliated hospital of southwest medical university were divided into three groups according to the BMI: the normal group (n = 40), the overweight group (n = 30) and the obese group (n = 30). The general data, related laboratory test results and the three-dimensional dynamic images of left ventricular were collected in all the study participants, and the relevant parameters of left ventricular spherical index and synchronicity were obtained by RT-3DE technique. To compare the differences between left ventricular spherical index and synchronicity parameters in each group. The influence factors of left ventricular geometric deformation and synchronicity changes in overweight and obese were analyzed. Results There were significant differences in systolic blood pressure, diastolic blood pressure, cholesterol, triglyceride and low density lipoprotein among the three groups (P < 0.05). There were significant differences in EDSI, ESSI, DDI and SDI among the three groups (P < 0.05). Left ventricular EDSI, ESSI, DDI and SDI were positively correlated with BMI and WC respectively. Stepwise multiple linear regression revealed that WC was correlated with left ventricular EDSI and BMI was correlated with left ventricular ESSI, DDI and SDI. Conclusions Left ventricular geometric shape tends to sphere and left ventricular wall motion synchronicity decreases in overweight and obese people. BMI and WC may be influence factors of left ventricular geometric deformation and synchronicity changes in overweight and obese people.