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Background Patients with congenital scoliosis often also have intraspinaJ abnormalities and other organ defects, and few studies of the effects of congenital scoliosis on cardiac function and structure have been published.Methods A total of 215 adolescent patients with congenital scoliosis (average age, 13.58 years) underwent preoperative echocardiography and were then assigned to subgroups according to apex vertebral rotation, side of convexity, curvature severity in the coronal and sagittal planes, type of deformity, and sex. Differences between the subgroups were compared by independent-samples ttest or a one-factor analysis of variance.Results We observed statistically significant differences between patients with right-sided scoliosis curvature and those with left-sided scoliosis curvature, respectively, in left ventricular inner diameter at end-diastole ((39.39±4.66)mm vs (41.74±4.90)mm), left ventricular inner diameter at end-systole ((24.8±3.45)mm vs (25.92±3.07)mm), interventricular septum thickness at end-diastole ((5.66±0.98)mm vs (5.98±1.03)mm), and posterior wail of left ventricle at end-diastole ((5.61±0.98)mm vs (6.06±1.20)mm). When the patients were evaluated by coronal plane Cobb angle, significant differences were found between those with Cobb angle of 40Ω-80Ω and of >80Ω in left ventricular inner diameter at end-diastole ((40.97±5.06)mm vs (38.98±4.45)mm) and left ventricular inner diameter at end-systole ((25.53±3.39)mm vs (24.36±3.14)mm), respectively. When the patients were evaluated by sagittal plane Cobb angle (<20Ω, group 1; 20Ω40Ω, group 2; >40Ω, group 3), significant differences were found in right ventricular diameter between those with Cobb angle of <20Ω and of 20Ω-40Ω ((18.27±3.66)mm vs (16.54±3.57)mm) and in diameter of aortic root between those with Cobb angle of 20Ω-40Ω and of >40Ω ((23.83±3.39)mm vs (24.90±3.30)mm), respectively. No significant differences were found in ejection fraction and fractional shortening between patients according to apex vertebral rotation, side of convexity, coronal plane and sagittal plane Cobb angles, type of deformity, or sex.Conclusiona Congenital scoliosis influences cardiac structure, but not function.