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Atrial strain and motion play important roles in evaluation of stroke risks for patients with atrial fibrillation. While cardiac computed tomographic angiography (CTA) provides detailed left atrial morphology with unparallel image resolution, finding a suitable strain measurement method for CTA remains a considerable challenge. In this paper, for the first time, we introduced a mesh regularized image block matching method to estimate 3D left atrial (LA) surface strain with 4D CTA. A series of performance tests with ex-vivo phantom and in-vivo 4D-CTA data were deployed. In conclusion, our proposed method could provide reliable LA motion and strain data within limited time., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)