<p>Left ventricular hypertrophy (LVH) is a major cardiac complication of hypertension. The ratio of triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) (TG/HDL-C) has been identified as a biomarker of insulin resistance and a predictor of atherosclerosis. We aimed to investigate the relationship between TG/HDL-C and LVH in hypertensive patients among the Han Chinese. Our community-based cross-sectional study recruited 4552 patients with hypertension. LVH was diagnosed by transthoracic echocardiography in these patients based on a criterion of left ventricular mass index (LVMI) over 49.2&#xa0;g/m^2.7 in men and 46.7&#xa0;g/m^2.7 in women. The independent association between the TG/HDL-C ratio quartiles and LVH prevalence was analyzed by logistic regression models. The ratio of TG/HDL-C was higher (1.27 ± 1.26, 1.15 ± 1.07, <i>P</i> = 0.001) in LVH patients. The prevalence of LVH with the first quartile of TG/HDL-C (Q1: &lt; 0.61), second (Q2: 0.61 ~ 0.91), the third (Q3: 0.92 ~ 1.41), and the highest quartile (Q4: &gt;1.41) was 36.1%, 42%, 42.6%, 44.9%, respectively. Logistic regression analysis suggested that the ratio of TG/HDL-C was independently correlated with the risk of LVH with adjustment of confounding factors. The correlation was more significant in female patients rather than males. Compared to the first quartile of TG/HDL-C (Q1), the odds ratios (ORs) and their 95% confidence intervals (CIs) for LVH in the increasing quartiles (Q2-Q4) were 1.21(1.01–1.45), 1.28(1.07–1.54), and 1.48(1.23–1.78), respectively. Similar results were also observed in the subjects younger than 60 years with coronary heart disease (CAD). The ratio of TG/HDL-C may be an independent risk factor of LVH in Han Chinese with hypertension.</p>