Purpose: Exercise-induced pulmonary hypertension (EIPH), assessed using exercise stress echocardiography (ESE), is important in diagnosing early stage of heart failure (HF) with preserved ejection fraction (EF) and affects exercise tolerance and prognosis. Left atrial (LA) reservoir strain, which reflects the left ventricular filling pressure, is an important factor in the diagnosis of HF. This study aimed to investigate the association between the LA reservoir strain at rest and EIPH. Methods: This retrospective analysis included 188 participants with a left ventricular EF ≥ 50% who underwent ESE. EIPH was defined as a peak tricuspid regurgitation (TR) pressure gradient > 50 mmHg. HF events (HF hospitalization or diuretic use with brain natriuretic peptide ≥ 100 pg/mL) were evaluated in patients with ≥ 3 months follow-up. Results: Thirty-four (18.1%) patients were diagnosed with EIPH. LA reservoir strain at rest with an optimal cutoff value of 21% identified patients, with 73% sensitivity and 59% specificity. Among the resting echocardiographic parameters, LA reservoir strain was independently associated with EIPH (odds ratio; 0.93, P = 0.018). Furthermore, adding LA reservoir strain to the TR-velocity significantly improved EIPH discrimination. During a median follow-up period of 336 days, 29 patients (21.6 %) experienced HF events. Patients with LA reservoir strain ≤ 21% had a fourfold increased risk of HF events after adjusting for age and HFA-PEFF score. Conclusion: LA reservoir strain at rest was associated with EIPH and HF events in patients with preserved EF, suggesting that impaired LA reservoir strain could increase the risk of HF.