The importance of hypertension to the structure and function of the cardiovascular system has been well recognized for several decades. The relationship between BP and risk of CVD events is continuous, consistent, and independent of other risk factors. Worldwide prevalence estimates for hypertension may be as much as 1 billion individuals, and approximately 7.1 million deaths per year may be attributable to hypertension, which is the number one attributable risk for death throughout the world. Therefore, optimal evaluation and management of hypertensive patients are crucial in clinical practice. Diagnostic procedures for hypertensive patients should include; 1) to establish blood pressure levels, 2) to identify secondary causes of hypertension, and 3) to evaluate the overall cardiovascular risk by searching for other risk factors, target organ damage and concomitant diseases or accompanying clinical conditions. Echocardiography is a robust, noninvasive diagnostic technique that can be repeated many times and used to study large cohorts of patients. It has provided valuable clinical information regarding the geometry and function of the left ventricle including left ventricular mass, hypertrophy and systolic and diastolic function. Therefore, tons of data demonstrating the usefulness of various echocardiographic parameters as predictors of cardiac morbidity and mortality have been accumulated. Although technical variability and cost remain practical limitations, the clinical usefulness of information it has provided about hypertension should be understood by all physicians.