Objective: Epicardial adipose tissue (EAT) secretes various inflammatory mediators and growth factor, and has endocrine and paracrine effects on myocardium and body. We planned the present study in order to evaluate the possible relationship between EAT and left ventricular mass (LVM), a potent predictor of cardiovascular mortality and morbidity, independent of age, blood pressure and the metabolic parameters in patients with hypertension (HT). Methods: The present study was cross-sectional and observational, including consecutive 107 untreated essential hypertensive patients who underwent a complete transthoracic echocardiographic examination as well as measurements of LVM and EAT. Blood pressure, routine blood chemistry, C-reactive protein, and patient characteristics were also recorded. Univariate and then multiple linear regression analyses were used for analysis of independent variables associated with EAT. Results: LVM significantly correlated with waist circumference, EAT, glucose, uric acid, high-density lipoprotein (HDL) cholesterol, and systolic and diastolic blood pressure. When we divided study population into two groups according to median mean blood pressure (BP) (Mean BP ≤116 vs. >116 mmHg), EAT was the only associated factor for LVM in patients below median BP (Beta: 0.518, p<0.001). Linear regression analyses revealed EAT to be independently associated with LVM (Beta: 0.419; p<0.001) and LVM index (Beta: 0.384, p<0.001) as well as high-density lipoprotein (Beta: -0.264, p=0.006). Conclusion: EAT was related to increased LVM independent of BMI, waist circumference, weight, systolic and diastolic blood pressure and other risk parameters, in patients with HT. Determination of increased EAT by echocardiography may have an additional value as an indicator of cardiovascular risk and total visceral adipose tissue