Background <p>Previous studies have found that subclinical dysfunction was associated with coronary artery dilation in patients with Kawasaki disease. However, cardiac function and myocardial tissue characteristics have rarely been studied in Kawasaki disease patients without coronary artery dilation.</p> Objective <p>Our study aims to evaluate cardiac dysfunction and myocardial tissue characteristics in Kawasaki disease patients without coronary artery dilation using cardiac magnetic resonance imaging (MRI) and then investigate the association between subclinical dysfunction and myocardial abnormalities.</p> Materials and methods <p>Seventy-two (48 males, average age 6.2 ± 4.5&#xa0;years) Kawasaki disease patients without coronary artery dilation and 30 control patients (20 males, average age 6.8 ± 3.3&#xa0;years) were retrospectively enrolled in this study. Strain parameters and mapping values were compared between Kawasaki disease patients and control patients.</p> Results <p>The left ventricular ejection fraction (LVEF) of Kawasaki disease patients is in the normal range. However, the global longitudinal strain of patients is lower than that of control patients (-13.2 ± 3.9 vs. -15.1 ± 4.2%, <i>P</i> = 0.03). The global native T1 value of Kawasaki disease patients is higher than that of control patients (1,306.5 ± 75.2 vs. 1,264.3 ± 65.5&#xa0;ms, <i>P</i> = 0.04). Pearson’s analysis shows that the global native T1 value is correlated with global longitudinal strain (<i>r</i> = 0.22, <i>P</i> &lt; 0.01) in Kawasaki disease patients. Further multiple linear regression analysis finds the global T1 value is independently associated with global longitudinal strain (<i>β</i> = 0.11, <i>P</i> = 0.01) after adjusting for age and sex.</p> Conclusion <p>Kawasaki disease patients without coronary artery dilation suffer subclinical dysfunction, which may be associated with myocardial abnormalities during the chronic phase.</p> Graphical Abstract <p></p>