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Background and Aims Thoracic erector spinae plane (ESP) block is widely used for postoperative and even chronic pain management in various surgical procedures. However, limited data exist on the effects of left-sided thoracic ESP block on left ventricular (LV) function. This study aimed to evaluate the effects of thoracic ESP block on LV function.Methods 23 patients aged 18–75 years, classified as ASA I–III and scheduled for elective thoracic surgery and had no known cardiac disease, were included in this prospective study. Ethical approval was obtained, and the study was registered with ClinicalTrials.gov before the enrollment of the first patient. After obtaining verbal and written consent, a left thoracic ESP block was performed at the T5 level using 20 ml of 0.25% bupivacaine. Hemodynamic and transthoracic echocardiographic parameters—including heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), left ventricular outflow tract (LVOT) diameter, strain, cardiac output (CO), end-diastolic diameter (EDD), and end-systolic diameter (ESD)—were measured before and 15 minutes after the block.Results Following the block, significant decreases were observed in HR (p<0.001), SBP (p=0.004), and DBP (p=0.010), while significant increases were noted in EDD (p<0.001), ESD (p=0.019), and end-diastolic volume (p=0.002). No significant changes were detected in EF, LVOT diameter, CO, or strain (p>0.05).Conclusions Left thoracic ESP block may induce measurable changes in certain cardiovascular parameters. However, its impact on clinical outcomes requires further investigation through larger-scale studies.