【Abstract】Objective To investigate the relationship between ambulatory pulse pressure and left ventricular hypertrophy in essential hypertensive patients and provide useful message for preventing heart damage in hypertensive patients.Method This hospitalbased retrospective cohort study was included 672 essential hypertensive patients underwent ambulatory blood pressure monitoring and echocardiography. Multiple linear regression was used to investigate the relationship between ambulatory pulse pressure and left ventricular hypertrophy, and the receiver characteristic (ROC) curve was used to evaluate the predictive value. Results Among 672 patients with essential hypertension, 258 (414%) had left ventricular hypertrophy. Multiple linear regression analysis showed that 24hour ambulatory pulse pressure was significantly correlated with left ventricular mass index (P＜0002). The AUC of 24hour ambulatory pulse pressure in predicting left ventricular hypertrophy was 064, and that of 24hour systolic pressure was 058. After AUC comparison, 24hour ambulatory pulse pressure was better than 24hour systolic pressure in predicting left ventricular hypertrophy (P＜0001). Conclusion 24h ambulatory pulse pressure is closely related to left ventricular hypertrophy in essential hypertensive patients, and it is superior to 24h systolic pressure in the prediction of left ventricular hypertrophy.